Medicare Supplement Insurance Plan*G offers the most comprehensive protection available to Oklahoma seniors looking to enhance Original Medicare. This plan from Blue Cross and Blue Shield of Oklahoma, A Division of Health Care Service Corporation can offer deserving seniors the peace of mind they deserve with a plan they can depend on from a trusted provider.

Benefits

This Plan offers 100 percent coverage for your Part A deductible ($1,484) as well as total coverage for the remaining charge for days 61-90 in the hospital after Medicare pays ($370 a day). For days 91 and beyond, this plan pays for 100 percent of Medicare-eligible expenses and 365 extra days of coverage after Lifetime Reserve is used up. This plan also pays for all costs of receiving skilled nursing care until day 101, 100 percent of the costs of the first three pints of blood and your Medicare copayment/coinsurance for hospice care.

Medical expenses that you incur in or out of the hospital and outpatient hospital treatment can be costly. With this plan, you can count on coverage for the remainder of any Medicare-approved amount (after your Part B deductible is paid in full), 100 percent of Part B excess charges.

Benefits Summary

• Part A deductible and coinsurance
• 365 extra days of hospital care after Medicare benefits end
• Part B deductible, coinsurance and 100 percent of excess charges
• Skilled nursing facility copayment, hospice care, and home healthcare approved services
• 100 percent coverage for the first three pints of blood
• After a $250 cost, 80 percent foreign travel emergency care (up to $50,000 lifetime)

What You Can Expect to Pay

With comprehensive coverage from Medicare Supplement Insurance Plan G, you can expect to pay your Part B deductible, all hospitalization costs after an additional 365 days after the lifetime Reserve are used, all costs of skilled nursing facility care after 101 days and a foreign travel deductible of $250 annually plus 20 percent of costs within the first $50,000.

Blue Cross and Blue Shield of Oklahoma will never terminate or refuse to renew your policy because of the condition of your health. As long as you continue to pay your premium.

Benefits Medicare does not pay in 2023	Expenses covered by our plans
	Plan A	Plan F	High Deductible Plan F	Plan N*
Part A (Hospital Services)**
$1,600 Medicare hospital deductible
$400 per day copayment for covered expenses for days 61-90 in the hospital
$800 per day copayment for covered expenses while you use your Lifetime Reserve
100% of Medicare allowable expenses for additional 365 days after Medicare hospital benefits stop completely
Calendar year blood deductible (charges for the first three pints of blood)
$200.00 per day for days 21-100 in a skilled nursing facility
Hospice care (Medicare Part A)
Part B (Physician’s Care and Medical Services)
$226 Part B deductible
Coinsurance for medical expenses (25% of Medicare approved amount for preventive services and 20% for the most others)				Generally 20% except up to $20 copayment for office visit and up to $50 ER
100% of Medicare Part B excess charges (above Medicare approved amounts)
Coinsurance for durable medical equipment (20% of Medicare-approved amounts)
Additional Expenses Not Covered by Medicare
Benefits for medically necessary emergency care received in a foreign country

* Plan F also has an option called a high-deductible Plan F. This high-deductible plan pays the same or offers the same benefits as Plan F after one has paid a calendar year $2,700 deductible. Benefits from high-deductible Plan F will not begin until out-of-pocket expenses are $2,700. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B but do not include the plan’s separate foreign travel emergency deductible.

** Hospital benefits must be provided by facilities participating in Medicare. Payments are limited to the reasonable charge as determined by Medicare.

*** After 90 days of hospitalization, Medicare benefits are paid from a one-time lifetime reserve of 60 additional days (days 91-150) which are not renewable for each benefit period. See your Outline of Coverage for details and limitations of these benefits.

† After the $226 Part B deductible is met for Plans A, F, High Deductible Plan F, and Plan N.

†† Foreign Travel Emergency covered at 80% after the first $250 each is paid each calendar year; up to $ 50,000-lifetime maximum.