A B C D F G K L M N
Part A coinsurance & hospital costs100%100%100%100%100%100%100%100%100%100%
Part B coinsurance100%100%100%100%100%100%50%75%100%100%
First 3 pints of blood100%100%100%100%100%100%50%75%100%100%
Part A hospice care coinsurance100%100%100%100%100%100%50%75%100%100%
Skilled Nursing Facility care coinsuranceXX100%100%100%100%50%75%100%100%
Part A deductible ($1,364 per benefit period)X100%100%100%100%100%50%75%50%100%
Part B deductible ($185 per year in 2019)XX100%X100%XXXXX
Part B excess chargesXXXX100%100%XXXX
Foreign travel emergency coverageXX80%80%80%80%XX80%80%
Out of Pocket LimitXXXXXX$5,880$2,940XX