Jon Godfread, Commissioner
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Premium Comparison
Premium Comparison
Age chosen = 78
Medigap benefits
A
B
C
D
F*
G
K
L
M
N
Basic Benefits (see below)
Part A: Inpatient hospital deductible
50%
75%
50%
Part A: Skilled-nursing facility co-insurance
50%
75%
Part B: Deductible
Foreign travel emergency**
80%
80%
80%
80%
Part B: Excess charges
2018 out-of-pocket limit
$5,240***
$2,620***
Please select the plan that
you are interested in.
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High
Deductible
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Medicare Select Plans
Basic benefits include:
Part A daily hospital inpatient co-insurance charges
All hospital costs after the Medicare benefit is used up
Part B co-insurance charges (except N: $20 copay per office visit, $50 copay per emergency room visit)
Part B co-insurance charges for palliative drugs during respite care and respite care charges
First three pints of blood
*
Medigap Plan F also offers a high-deductible option. You must pay for Medicare-covered costs up to the high-deductible amount ($2,240 in 2018) before your Medigap policy pays anything.
**
You must also pay a separate deductible for foreign travel emergency ($250 per year). Lifetime Limit of $50,000.
***
After you meet your out-of-pocket yearly limit and your yearly Part B deductible, the plan pays 100% of covered services for the rest of the calendar year.
****
Must cover at least part of the basic benefit.
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600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
Toll free 800.247.0560
Fax 701.328.4880
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