Medicare Supplement Plan

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MedigapBlue MedigapBlue SM Medicare Supplement Plan The plan that covers what Medicare leaves out Look Inside!

You have good reasons to choose a Highmark MedigapBlue Medicare Supplement plan. Decades of serving our neighbors, right here at home For over 70 years, Highmark has been caring for Pennsylvanians with reliable, friendly representatives and coverage you can count on. That s why so many people with Medicare turn to Highmark for high-quality health protection at some of the most affordable prices around. All Medigap plans are not equal The federal government standardizes Medicare Supplement plans, meaning their Medicare benefits must be the same. But not all of these plans carry the same advantages. It s true that one company s plan must provide the same benefits as another company s plan, but rates and services are not necessarily identical. You could pay more for the same benefits and get less value. You could save substantially with MedigapBlue and get the same benefits you have now plus more with value-added features from Highmark. Help is just a call away. Come to one of our neighborhood Medicare Solutions Seminars, where you ll get your questions answered by an expert. You can even get help to complete your application there. Or, call our Medicare-dedicated staff toll-free at 1-877-987-4876 (TTY/TDD users may call 1-800-345-3816), 8 a.m. 8 p.m., seven days a week.

MedigapBlue Medicare Supplement plan Below, just match up the benefits you want with the plan that s right for you. If you have any questions, give us a call. Our Medicare-dedicated representatives can help you find the plan that fits your needs. Don t let the Medicare deadline pass. Enroll today! Services Plan Deductible Hospitalization Days 1-60 Days 61-90 Days 91 and after: Using 60 lifetime reserve days After lifetime reserve days, additional 365 days Medicare Pays: All but $1,156 (Part A Ded) All but $289/day All but $578/day Beyond additional 365 days Skilled Nursing Days 1-20 All approved amounts Days 21-100 All but $144.50/day Days 101 and after Medical Expenses Including physician office visits, surgery, supplies, diagnostic tests, and physical and speech therapy First $140 of Medicare Approved Amounts Office Visits Emergency Room Visits Remainder of Medicare Approved Amounts Generally 80% Part B Excess Charges (above Medicare approved amounts) Home Health Care Medically necessary skilled care services and supplies All Durable Medical Equipment First $140 of Medicare Approved Amounts Remainder of Medicare Approved Amounts 80% Foreign Travel First $250 each calendar year Charges up to $50,000 lifetime maximum Charges after $50,000 lifetime maximum Prescription Drugs Not Covered For a more complete listing of benefits, please see the enclosed outline of coverage Available to all Medicare-eligible beneficiaries Plan A Plan B Plan C Plan F HD You Pay: $2,070 $1,156 after plan ded after plan ded after plan ded after plan ded $144.50/day $144.50/day after plan ded $140 (Part B Ded) $140 (Part B Ded) after plan ded $140 (Part B Ded) $140 (Part B Ded) after plan ded $140 (Part B Ded) $140 (Part B Ded) after plan ded after plan ded after plan ded $140 (Part B Ded) $140 (Part B Ded) after plan ded after plan ded $250 $250 20% 20% Not Covered - discount only Consider a stand-alone Part D drug plan Available to first-eligible and other qualified Medicare beneficiaries Plan F Plan N You Pay: $140 (Part B Ded) Lesser of $20 copay or Part B coinsurance Lesser of $50 copay or Part B coinsurance Other expenses: All Costs $140 (Part B Ded) $250 $250 20% 20% Not Covered - discount only Consider a stand-alone Part D drug plan

Highmark MedigapBlue covers costs that Medicare leaves out, giving you: Coverage for hospital and medical expenses not covered by Medicare Freedom to choose doctors, hospitals and providers at home or when you travel The ability to choose any doctor, specialist or hospital that accepts Medicare, with no limitations and no referrals Guaranteed coverage with no questions about your health or medical history and no medical underwriting requirements Special discounts on vision care Easy Ways to Enroll: Mail: In Person: Fill out the enclosed application and mail it in the envelope we ve provided. Attend a Highmark Medicare Solutions Seminar and complete your application there. Call the toll-free number to find a meeting in your area. Need help? Get answers: Call toll-free 1-877-987-4876 (TTY/TDD users may call 1-800-345-3816), 8 a.m. 8 p.m., seven days a week. Learn more about the plans we offer at www.highmarkblueshield.com/medicare.

MedigapBlue Highmark is a registered mark of Highmark Inc. Highmark Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association. Blue Shield and the Shield symbol are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. MedigapBlue is a service mark of the Blue Cross and Blue Shield Association. Printed on recycled paper. Please recycle. MG-C-C 12/11 22283 (Rev 12/11) 1111