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Home > SHIC > Medicare Supplement > Premium Comparison
Premium Comparison


Age chosen = 78

Medigap benefits A B C D F* G K L M  N  
Basic benefits D has Basic benefits D has Basic benefits D has Basic benefits D has Basic benefits D has Basic benefits D has Basic benefits D has Basic benefits **** D has Basic benefits **** D has Basic benefits D has Basic benefits
Part A: Inpatient hospital deductible D has Part A: Inpatient hospital deductible D has Part A: Inpatient hospital deductible D has Part A: Inpatient hospital deductible D has Part A: Inpatient hospital deductible D has Part A: Inpatient hospital deductible 50% 75% 50% D has Part A: Inpatient hospital deductible
Part A: Skilled-nursing facility co-insurance D has Part A: Skilled-nursing facility co-insurance D has Part A: Skilled-nursing facility co-insurance D has Part A: Skilled-nursing facility co-insurance D has Part A: Skilled-nursing facility co-insurance 50% 75% D has Part A: Skilled-nursing facility co-insurance D has Part A: Skilled-nursing facility co-insurance
Part B: Deductible D has Part B: Deductible D has Part B: Deductible
Foreign travel emergency** D has Foreign travel emergency** D has Foreign travel emergency** D has Foreign travel emergency** D has Foreign travel emergency** D has Foreign travel emergency** D has Foreign travel emergency**
Part B: Excess charges 100% 100%
2010 out-of-pocket limit $4,620*** $2,310***  
 
Please select the plan that
you are interested in.		 Details Details Details Details Details

High
Deductible
Details		 Details Details Details Details Details
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 ($2000 in 2010) before your Medigap policy pays anything.

**
You must also pay a separate deductible for foreign travel emergency ($250 per year).

***
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.

If you have additional questions, please call 1-888-575-6611 or email us at: ndshic@nd.gov

Return to the Medicare Supplement Home page

North Dakota Insurance Department
600 E. Boulevard Ave.
Bismarck, ND 58505-0320
Phone 701.328.2440
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Fax 701.328.4880

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