Medicare Supplement Plans A, C, F, G, K, L, And N Rates Effective Jan .

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Outline of CoverageMIMEDICARE SUPPLEMENT INSURANCEMedicare Supplement Plans A, C, F, G, K, L, and NRates effective Jan. 1, 2022MI MSO 2006

Outline of Medicare Supplement CoverageBenefit Chart of Medicare Supplement Plans Sold with Effective Dates On or After January 1, 2020This chart shows the benefits included in each of the standardized Medicare supplement plans. Every companymust make Plan A available. Some plans may not be available. Only applicants first eligible for Medicare before2020 may purchase Plans C, F, and high deductible F.Plans Available to All ApplicantsBenefitsMedicare Part Acoinsurance andhospital coverage(up to an additional365 days afterMedicare benefitsare used up)Medicare Part Bcoinsurance orcopaymentBlood (first threepints)Medicare Part Ahospice carecoinsurance orcopaymentSkilled nursingfacility coinsuranceMedicare Part AdeductibleMedicare Part BdeductibleMedicare Part Bexcess chargesMedicare firsteligible before2020 onlyCF1ABDG1KLMN 50%75% Copaysapply3 50%75% 50%75% 50%75% 50%75%50% Foreign travelemergency (up toplan limits)Out-of-pocket limitin 20222 6,6202 3,3102 indicates 100% of the benefit is paid.Plans shaded in gray are offered by WPS Health Insurance.Plans F and G also have high deductible options which require first paying the plans’ deductibles of 2,370before the plans begin to pay. Once the plans’ deductibles are met, the plans pay 100% of covered servicesfor the rest of the calendar year. High deductible Plan G does not cover the Medicare Part B deductible.However, high deductible Plans F and G count your payments of the Medicare Part B deductible towardmeeting the plan deductibles.1Plans K and L pay 100% of covered services for the rest of the calendar year once you meet the out-ofpocket yearly limits.2Plan N pays 100% of the Medicare Part B coinsurance, except for copayments of up to 20 for some officevisits and up to 50 copayments for emergency room visits that do not result in inpatient admissions.3

Premium InformationWPS Health Insurance can only raise your premium if we raise the premium for all policies like yours in this state,you enter a new age category, your residence changes such that you move to a new rating area, or if there is achange in Medicare benefits. If your policy was issued as an under age 65 policy due to a disability, when you turnage 65, your premiums will remain at the disabled rates.DisclosuresUse this outline to compare benefits and premiums among policies.Read Your Policy Very CarefullyThis is only an outline describing your policy’s most important features. The policy is your insurance contract. Youmust read the policy itself to understand all of the rights and duties of both you and your insurance company.Right to Return PolicyIf you find that you are not satisfied with your policy, you may return it to: WPS Health Insurance, P.O. Box 8190,Madison, WI 53708-8190. If you send the policy back to us within 30 days after you receive it, we will treat thepolicy as if it had never been issued and return all of your payments directly to you.Policy ReplacementIf you are replacing another health insurance policy, do NOT cancel it until you have actually received your newpolicy and are sure you want to keep it.NoticeThis policy may not fully cover all of your medical costs. Neither WPS Health Insurance nor its agents areconnected with Medicare. This Outline of Coverage does not give all the details of Medicare coverage. Contactyour local Social Security office or consult Medicare and You for more details.Complete Answers are Very ImportantWhen you fill out the application for the new policy, be sure to answer truthfully and completely all questions aboutyour medical and health history. The company may cancel your policy and refuse to pay any claims if you leave outor falsify important medical information. Review the application carefully before you sign it and be certain that allinformation has been properly recorded.

ANNUALIZED PREMIUM RATESZIP codes 480xx - 485xx, and moving out-of-stateFEMALEAgeUnder 65656667686970717273747576777879808182838485 Plan .004,282.564,411.204,543.80Plan 011.925,162.525,317.44Plan 461.202,534.882,610.96Plan 125.163,219.003,315.48Plan 375.804,507.084,642.44Plan .405,373.005,533.925,700.12Plan 538.965,705.165,876.52AgeUnder 6565Plan A7,184.402,564.28Plan GN/A3,001.20Plan KN/A1,473.36Plan LN/A1,871.28Plan NN/A2,619.84Plan C9,291.363,217.08Plan 85 9.126,529.086,724.92MALETIP: For monthly rates, shown with available discounts, please see theMedicare supplement booklet that accompanies this Outline of Coverage.Effective date: Jan. 1, 2022

ANNUALIZED PREMIUM RATESAll other Michigan ZIP codesAgeUnder 65656667686970717273747576777879808182838485 Plan .003,031.203,122.283,216.12Plan 547.443,654.003,763.68FEMALEPlan 794.241,848.00Plan 211.962,278.442,346.72Plan 097.203,190.083,285.96Plan .163,803.043,916.924,034.52Plan 920.524,038.124,159.44MALEAgeUnder 6565Plan A5,085.121,815.00Plan GN/A2,124.24Plan KN/A1,042.80Plan LN/A1,324.44Plan NN/A1,854.36Plan C6,576.482,277.00Plan 85 6.804,621.324,759.92TIP: For monthly rates, shown with available discounts, please see theMedicare supplement booklet that accompanies this Outline of Coverage.Effective date: Jan. 1, 2022

PLAN AMedicare Supplement Part A—Hospital Services —per benefit periodServicesMedicare PaysPlan PaysHOSPITALIZATION*First 60 daysAll but 1,556 0Semiprivate room andboard, general nursing, andAll but 389 389 a daymiscellaneous services and 61st to 90th dayper daysupplies.91st day and after whileAll but 778using 60 lifetime reserve 778 a dayper daydays100% ofOnce lifetime reserve daysMedicareare used: 0eligible—Additional 365 daysexpenses—Beyond the additional 365 0 0daysSKILLED NURSINGAll approved 0First 20 daysFACILITY CARE*amountsYou must meet Medicare’sAll but 194.50requirements, including21st to 100th day 0per dayhaving been in a hospital forat least 3 days and entereda Medicare-approved facility101st day and after 0 0within 30 days after leavingthe hospital.First 3 pints 03 pintsBLOODAdditional amounts100% 0All but verylimitedHOSPICE CAREcopayment/MedicareYou must meet Medicare’s requirements, including acoinsurance for copayment/doctor’s certification of terminal illness.outpatient drugs coinsuranceand inpatientrespite careYou Pay 1,556 (Part Adeductible) 0 0 0**All costs 0Up to 194.50per dayAll costs 0 0 0* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you havebeen out of the hospital and have not received skilled care in any other facility for 60 days in a row.** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicareand will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s“Core Benefits.” During this time, the hospital is prohibited from billing you for the balance based on any differencebetween its billed charges and the amount Medicare would have paid.

PLAN AMedicare Supplement Part B—Medical Services —per calendar yearServicesMedicare PaysPlan PaysMEDICAL EXPENSESIn or out of the hospital and First 233 of Medicare 0 0outpatient hospital treatment, approved amounts***such as physician’s services,inpatient and outpatientmedical and surgicalRemainder of Medicareservices and supplies,Generally 80% Generally 20%physical and speech therapy, approved amountsdiagnostic tests, durablemedical equipment.PART B EXCESS CHARGES 0 0(Above Medicare-approved amounts)BLOODFirst 3 pintsNext 233 of Medicareapproved amounts***Remainder of Medicareapproved amountsCLINICAL LABORATORY SERVICESTests for diagnostic servicesMedicare Parts A & BServices—Durable medicalequipment 233 (Part Bdeductible) 0All costs 0All costs 0 080%20% 0100% 0 0Medicare PaysHOME HEALTH CARE (Medicare-approved services)—Medically necessary skilled care services and medicalsuppliesYou Pay 0 233 (Part Bdeductible)Plan PaysYou Pay100% 0 0First 233 of Medicareapproved amounts*** 0 0 233 (Part Bdeductible)Remainder of Medicareapproved amounts80%20% 0*** Once you have been billed 233 of Medicare-approved amounts for covered services, your Part B deductiblewill have been met for the calendar year.Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People withMedicare.

PLAN GMedicare Supplement Part A—Hospital Services —per benefit periodServicesMedicare PaysHOSPITALIZATION*First 60 daysAll but 1,556Semiprivate room andboard, general nursing, andAll but 389miscellaneous services and 61st to 90th dayper daysupplies.91st day and after whileAll but 778using 60 lifetime reserveper daydaysOnce lifetime reserve daysare used:—Additional 365 daysHOSPICE CAREYou must meet Medicare’s requirements, including adoctor’s certification of terminal illness.You Pay 0 389 a day 0 778 a day 0100% ofMedicareeligibleexpenses 0** 0All costsAll approvedamounts 0 0All but 194.50per dayUp to 194.50per day 0 0 0All costs 0100%All but verylimitedcopayment/coinsurance foroutpatient drugsand inpatientrespite care3 pints 0 0 0Medicarecopayment/coinsurance 0 0—Beyond the additional 365 0daysSKILLED NURSINGFirst 20 daysFACILITY CARE*You must meet Medicare’srequirements, including21st to 100th dayhaving been in a hospital forat least 3 days and entereda Medicare-approved facility101st day and afterwithin 30 days after leavingthe hospital.First 3 pintsBLOODAdditional amountsPlan Pays 1,556 (Part Adeductible)* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you havebeen out of the hospital and have not received skilled care in any other facility for 60 days in a row.** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicareand will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s“Core Benefits.” During this time, the hospital is prohibited from billing you for the balance based on any differencebetween its billed charges and the amount Medicare would have paid.

PLAN GMedicare Supplement Part B—Medical Services —per calendar yearServicesMedicare PaysPlan PaysMEDICAL EXPENSESFirst 233 of MedicareIn or out of the hospital and 0 0outpatient hospital treatment, approved amounts***such as physician’s services,inpatient and outpatientmedical and surgicalservices and supplies,Remainder of MedicareGenerally 80% Generally 20%physical and speech therapy, approved amountsdiagnostic tests, durablemedical equipment.PART B EXCESS CHARGES(Above Medicare-approved amounts)BLOODFirst 3 pintsNext 233 of Medicareapproved amounts***Remainder of Medicareapproved amountsCLINICAL LABORATORY SERVICESTests for diagnostic servicesMedicare Parts A & BServicesHOME HEALTH CARE (Medicare-approved services) —Medically necessary skilled care services and medicalsuppliesFirst 233 of Medicareapproved amounts***—Durable medicalequipmentRemainder of Medicareapproved amountsOther Benefits—Not Covered by MedicareServicesFOREIGN TRAVEL—NOT First 250 eachCOVERED BY MEDICARE calendar yearMedically necessaryemergency care servicesbeginning during the firstRemainder of charges60 days of each trip outsidethe USA.You Pay 233 (Part Bdeductible) 0 0100% 0 0All costs 0 0 0 233 (Part Bdeductible)80%20% 0100% 0 0Medicare PaysPlan PaysYou Pay100% 0 0 0 0 233 (Part Bdeductible)80%20% 0Medicare PaysPlan PaysYou Pay 0 0 250 020% and80% to a lifetimeamounts overmaximum benefitthe 50,000of 50,000lifetime maximum*** Once you have been billed 233 of Medicare-approved amounts for covered services, your Part B deductible willhave been met for the calendar year.Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.

PLAN KMedicare Supplement Part A—Hospital Services —per benefit periodServicesMedicare PaysHOSPITALIZATION*First 60 daysAll but 1,556Semiprivate room andboard, general nursing, andAll but 389miscellaneous services and 61st to 90th dayper daysupplies.91st day and after whileAll but 778using 60 lifetime reserveper daydaysOnce lifetime reserve daysare used:—Additional 365 daysPlan Pays 778 (50%of Part Adeductible)You Pay† 778 (50%of Part Adeductible)w 389 a day 0 778 a day 0100% ofMedicareeligibleexpenses 0** 0All costsAll approvedamounts 0 0All but 194.50per dayUp to 97.25a day (50%of Part Acoinsurance)Up to 97.25a day (50%of Part Acoinsurance)w 0 0All costs 0100%All but verylimitedcopayment/coinsurance foroutpatient drugsand inpatientrespite care50% 050%w 050% ofcopayment/coinsurance50% ofcopayment/coinsurancew 0—Beyond the additional 365 0daysSKILLED NURSINGFirst 20 daysFACILITY CARE*You must meet Medicare’srequirements, includinghaving been in a hospital for 21st to 100th dayat least 3 days and entereda Medicare-approved facilitywithin 30 days after leaving 101st day and afterthe hospital.First 3 pintsBLOODAdditional amountsHOSPICE CAREYou must meet Medicare’s requirements, including adoctor’s certification of terminal illness.You will pay half the cost sharing of some covered services until you reach the annual out-of-pocket maximumof 6,620 each calendar year. The amounts that count toward your annual limit are noted with diamonds (w) inthe chart above. Once you reach the annual maximum, the plan pays 100% of your Medicare copayment andcoinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider thatexceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying thisdifference in the amount charged by your provider and the amount paid by Medicare for the item or service.†* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you havebeen out of the hospital and have not received skilled care in any other facility for 60 days in a row.** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicareand will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s“Core Benefits.” During this time, the hospital is prohibited from billing you for the balance based on any differencebetween its billed charges and the amount Medicare would have paid.

PLAN KMedicare Supplement Part B—Medical Services —per calendar yearServicesMedicare PaysMEDICAL EXPENSESFirst 233 of Medicare 0In or out of the hospitalapproved amounts***and outpatient hospitalGenerallytreatment, such as80% or morephysician’s services,Preventive benefits forof Medicareinpatient and outpatientMedicare-covered servicesapprovedmedical and surgicalamountsservices and supplies,physical and speechRemainder of Medicaretherapy, diagnostic tests,Generally 80%approved amountsdurable medical equipment.PART B EXCESS CHARGES(Above Medicare-approved amounts)First 3 pintsNext 233 of MedicareBloodapproved amounts***Remainder of Medicareapproved amountsCLINICAL LABORATORY SERVICESTests for diagnostic servicesMedicare Parts A & BServicesHOME HEALTH CARE (Medicare-approved services)—Medically necessary skilled care services and medicalsuppliesFirst 233 of Medicareapprovedamounts***—Durable medicalequipmentRemainder of Medicareapproved amountsPlan PaysYou Pay† 0 233 (Part Bdeductible)***wRemainderof MedicareapprovedamountsAll costs aboveMedicareapprovedamountsGenerally 10%Generally 10%wAll costs (andthey do notcount towardannual out-ofpocket limit of 6,620)††50%w 233 (Part Bdeductible)***w 0 0 050% 0 0Generally 80%Generally 10%Generally 10%w100% 0 0Medicare PaysPlan PaysYou Pay†100% 0 0 0 0 233 (Part Bdeductible)w80%10%10%wYou will pay half the cost sharing of some covered services until you reach the annual out-of-pocket maximumof 6,620 each calendar year. The amounts that count toward your annual limit are noted with diamonds (w) inthe chart above. Once you reach the annual maximum, the plan pays 100% of your Medicare copayment andcoinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider thatexceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying thisdifference in the amount charged by your provider and the amount paid by Medicare for the item or service.††This plan limits your annual out-of-pocket payments for Medicare-approved amounts to 6,620 per year. However,this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called“Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider andthe amount paid by Medicare for the item or service.*** Once you have been billed 233 of Medicare-approved amounts for covered services, your Part B deductible willhave been met for the calendar year.Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.†

PLAN LMedicare Supplement Part A—Hospital Services —per benefit periodServicesMedicare PaysHOSPITALIZATION*First 60 daysAll but 1,556Semiprivate room andboard, general nursing, andAll but 389miscellaneous services and 61st to 90th dayper daysupplies.91st day and after whileAll but 778using 60 lifetime reserveper daydaysOnce lifetime reserve daysare used:—Additional 365 daysPlan Pays 1,167 (75%of Part Adeductible)You Pay† 389 (25%of Part Adeductible)w 389 a day 0 778 a day 0100% ofMedicareeligibleexpenses 0** 0All costsAll approvedamounts 0 0All but 194.50per dayUp to 145.88a day (75%of Part Acoinsurance)Up to 48.62a day (25%of Part Acoinsurance)w 0 0All costs 0100%All but verylimitedcopayment/coinsurance foroutpatient drugsand inpatientrespite care75% 025%w 075% ofcopayment/coinsurance25% ofcopayment/coinsurancew 0—Beyond the additional 365 0daysSKILLED NURSINGFirst 20 daysFACILITY CARE*You must meet Medicare’srequirements, includinghaving been in a hospital for 21st to 100th dayat least 3 days and entereda Medicare-approved facilitywithin 30 days after leaving 101st day and afterthe hospital.First 3 pintsBLOODAdditional amountsHOSPICE CAREYou must meet Medicare’s requirements, including adoctor’s certification of terminal illness.You will pay one-fourth the cost sharing of some covered services until you reach the annual out-of-pocketmaximum of 3,310 each calendar year. The amounts that count toward your annual limit are noted with diamonds(w) in the chart above. Once you reach the annual maximum, the plan pays 100% of your Medicare copayment andcoinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider thatexceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying thisdifference in the amount charged by your provider and the amount paid by Medicare for the item or service.†* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you havebeen out of the hospital and have not received skilled care in any other facility for 60 days in a row.** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicareand will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s“Core Benefits.” During this time, the hospital is prohibited from billing you for the balance based on any differencebetween its billed charges and the amount Medicare would have paid.

PLAN LMedicare Supplement Part B—Medical Services —per calendar yearServicesMedicare PaysMEDICAL EXPENSESFirst 233 of Medicare 0In or out of the hospitalapproved amounts***and outpatient hospitalGenerallytreatment, such as80% or morePreventive benefits forphysician’s services,of MedicareMedicare-covered servicesinpatient and outpatientapprovedmedical and surgicalamountsservices and supplies,physical and speechRemainder of MedicareGenerally 80%therapy, diagnostic tests,approved amountsdurable medical equipment.PART B EXCESS CHARGES(Above Medicare-approved amounts)First 3 pintsNext 233 of MedicareBLOODapproved amounts***Remainder of Medicareapproved amountsCLINICAL LABORATORY SERVICESTests for diagnostic servicesMedicare Parts A & BServicesHOME HEALTH CARE (Medicare-approved services)—Medically necessary skilled care services and medicalsuppliesFirst 233 of Medicareapproved amounts***—Durable medicalequipmentRemainder of Medicareapproved amountsPlan Pays 0You Pay† 233 (Part Bdeductible)***wRemainderof MedicareapprovedamountsAll costs aboveMedicareapprovedamountsGenerally 15%Generally 5%wAll costs (andthey do notcount towardannual out-ofpocket limit of 3,310)††25%w 233 (Part Bdeductible)***w 0 0 075% 0 0Generally 80%Generally 15%Generally 5%w100% 0 0Medicare PaysPlan PaysYou Pay†100% 0 0 0 0 233 (Part Bdeductible)w80%15%5%wYou will pay one-fourth the cost sharing of some covered services until you reach the annual out-of-pocketmaximum of 3,310 each calendar year. The amounts that count toward your annual limit are noted with diamonds(w) in the chart above. Once you reach the annual maximum, the plan pays 100% of your Medicare copayment andcoinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider thatexceed Medicare-approved amounts (these are called “Excess Charges”) and you will be responsible for paying thisdifference in the amount charged by your provider and the amount paid by Medicare for the item or service.††This plan limits your annual out-of-pocket payments for Medicare-approved amounts to 3,310 per year. However,this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called“Excess Charges”) and you will be responsible for paying this difference in the amount charged by your provider andthe amount paid by Medicare for the item or service.*** Once you have been billed 233 of Medicare-approved amounts for covered services, your Part B deductible willhave been met for the calendar year.Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.†

PLAN NMedicare Part A—Hospital Services —per benefit periodServicesHOSPITALIZATION*First 60 daysSemiprivate room andboard, general nursing, andmiscellaneous services and 61st to 90th daysupplies.91st day and after whileusing 60 lifetime reservedaysOnce lifetime reserve daysare used:—Additional 365 daysMedicare PaysAll but 1,556HOSPICE CAREYou must meet Medicare’s requirements, including adoctor’s certification of terminal illness.You Pay 0All but 389per day 389 a day 0All but 778per day 778 a day 0 0100% ofMedicareeligibleexpenses 0** 0All costsAll approvedamounts 0 0All but 194.50per dayUp to 194.50per day 0 0 0All costs 0100%All but verylimitedcopayment/coinsurance foroutpatient drugsand inpatientrespite care3 pints 0 0 0Medicarecopayment/coinsurance 0—Beyond the additional 365 0daysSKILLED NURSINGFirst 20 daysFACILITY CARE*You must meet Medicare’srequirements, including21st to 100th dayhaving been in a hospital forat least 3 days and entereda Medicare-approved facility101st day and afterwithin 30 days after leavingthe hospital.First 3 pintsBLOODAdditional amountsPlan Pays 1,556 (Part Adeductible)* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you havebeen out of the hospital and have not received skilled care in any other facility for 60 days in a row.** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicareand will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s“Core Benefits.” During this time, the hospital is prohibited from billing you for the balance based on any differencebetween its billed charges and the amount Medicare would have paid.

PLAN NMedicare Part B—Medical Services —per calendar yearServicesMedicare PaysMEDICAL EXPENSESFirst 233 of Medicare 0In or out of the hospitalapproved amounts***and outpatient hospitaltreatment, such asphysician’s services,inpatient and outpatientmedical and surgicalservices and supplies,Remainder of MedicareGenerally 80%physical and speechapproved amountstherapy, diagnostictests, durable medicalequipment.PART B EXCESS CHARGES (Above Medicareapproved amounts)First 3 pintsNext 233 of Medicareapproved amounts***BLOODRemainder of Medicareapproved amountsCLINICAL LABORATORY SERVICESTests for diagnostic servicesMedicare Parts A & BServicesHOME HEALTH CARE (Medicare-approvedservices) —Medically necessary skilled care services andmedical suppliesFirst 233 of Medicareapproved amounts***—Durable medicalRemainder ofequipmentMedicare-approvedamountsOther Benefits—Not Covered by MedicareServicesFirst 250 eachFOREIGN TRAVEL—calendar yearNOT COVERED BYMEDICAREMedically necessaryemergency care servicesRemainder of chargesbeginning during thefirst 60 days of each tripoutside the USA.Plan PaysYou Pay 233 (Part B 0deductible)Balance, other than up Up to 20 perto 20 per office visit office visit and up to 50 per emergencyand up to 50 peremergency room visit. room visit. TheThe copayment of up copayment of up toto 50 is waived if the 50 is waived if theinsured is admittedinsured is admittedto any hospital andto any hospital andthe emergencythe emergencyvisit is covered asvisit is covered asa Medicare Part Aa Medica

Medicare Supplement Plans A, C, F, G, K, L, and N Rates effective Jan. 1, 2022 MI_MSO_2006. 1Plans F and G also have high deductible options which require first paying the plans' deductibles of 2,370 before the plans begin to pay. Once the plans' deductibles are met, the plans pay 100% of covered services

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