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Kansas Senior Plan C - Medicare Payment Information
Medicare A - Hospitalization	Medicare B - Medical	Kansas Senior Plan C Supplement
Inpatient hospital First 60 Days: $1,100 deductible* Days 61 through 90: $275 per day Coinsurance* Lifetime reserve: $550 per day Coinsurance* Skilled Nursing Facility First 20 days: 100% payment - no co-pay Days 21-100: $137.50 per day Coinsurance* Services Paid at 100% Home health Hospice Benefit period ends when the patient is out of the hospital or skilled nursing facility for 60 consecutive days There is usually no premium associated with Medicare Part A. Coverage shown is per benefit period. A benefit period ends when the patient is out of the hospital or skilled nursing facility for 60 consecutive days.	Annual Deductible $155 deductible per calendar year* (January 1 through December 31) Medicare Coverage for Physician's Charges Medicare pays 80% of allowed charge; Beneficiary pays 20% Coinsurance* (in- or out-of-hospital) Durable Medical Expenses and Supplies Ambulance Outpatient hospital charges Blood (first 3 pints) Lab services Preventive Services Bone mass measurement Cardiovascular screenings Colorectal screenings Diabetes screenings Flu shots Glaucoma tests Hepatitis B shots Pap tests Pneumococcal shot Prostate cancer screening Screening mammograms "Welcome to Medicare" physical exam (one-time) Routine physical exams with no specific diagnosis are not covered Beneficiary must pay a monthly Medicare Part B Premium of $96.40*	Kansas Senior Plan C pays for all costs shown in green to the left under Medicare Part A and Part B. In addition, Kansas Senior Plan C pays the following: An additional 365 hospital days per lifetime Foreign emergency travel medical services: $250 deductible, then the plan pays 80% to a maximum of $50,000 lifetime If Medicare A and B do not cover the service, there is no benefit under the medical portion of Kansas Senior Plan C
* The deductible and coinsurance amounts listed on this chart reflect 2009 rates. Be sure to review your Medicare and You handbook for the new 2010 amounts.

Kansas Senior Plan C - Medicare Payment Information

Medicare A - Hospitalization

Medicare B - Medical

Kansas Senior Plan C Supplement

Inpatient hospital

First 60 Days: $1,100 deductible*
Days 61 through 90: $275 per day Coinsurance*
Lifetime reserve: $550 per day Coinsurance*

Skilled Nursing Facility

First 20 days: 100% payment - no co-pay
Days 21-100: $137.50 per day Coinsurance*

Services Paid at 100%

Home health
Hospice
Benefit period ends when the patient is out of the hospital or skilled nursing facility for 60 consecutive days

There is usually no premium associated with Medicare Part A.

Coverage shown is per benefit period. A benefit period ends when the patient is out of the hospital or skilled nursing facility for 60 consecutive days.

Annual Deductible
$155 deductible per calendar year* (January 1 through December 31)

Medicare Coverage for Physician's Charges
Medicare pays 80% of allowed charge; Beneficiary pays 20% Coinsurance* (in- or out-of-hospital)

Durable Medical Expenses and Supplies

Ambulance
Outpatient hospital charges
Blood (first 3 pints)
Lab services

Preventive Services

Bone mass measurement
Cardiovascular screenings
Colorectal screenings
Diabetes screenings
Flu shots
Glaucoma tests
Hepatitis B shots
Pap tests
Pneumococcal shot
Prostate cancer screening
Screening mammograms
"Welcome to Medicare" physical exam (one-time) Routine physical exams with no specific diagnosis are not covered

Beneficiary must pay a monthly Medicare Part B Premium of $96.40*

Kansas Senior Plan C pays for all costs shown in green to the left under Medicare Part A and Part B. In addition, Kansas Senior Plan C pays the following:

An additional 365 hospital days per lifetime
Foreign emergency travel medical services: $250 deductible, then the plan pays 80% to a maximum of $50,000 lifetime
If Medicare A and B do not cover the service, there is no benefit under the medical portion of Kansas Senior Plan C

* The deductible and coinsurance amounts listed on this chart reflect 2009 rates. Be sure to review your Medicare and You handbook for the new 2010 amounts.