NCDOI | Standard Medicare Supplement Plan Benefits

Standard Medicare Supplement Plan Benefits

Note: Only applicants first eligible for Medicare before 2020 may purchase Plan F

Basic Benefits

Coverage for the Part A coinsurance amount ($408 per day in 2024) for the 61st through the 90th day of hospitalization in each Medicare benefit period.
Coverage for the Part A coinsurance amount ($816 per day in 2024) for each of Medicare's 60 non-renewable lifetime hospital inpatient reserve days used (91-150).
After all Medicare hospital benefits are exhausted, coverage for 100% of the Medicare Part A eligible hospital expenses. Coverage is limited to a maximum of 365 days of additional inpatient hospital care during the policyholder's lifetime. This benefit is paid either at the rate Medicare pays hospitals under its Prospective Payment System (PPS) or under another standard of payment of hospitals not subject to the PPS.
Coverage for the coinsurance amount for Part B services (generally 20% of approved amount; including outpatient mental health services) after $240 annual deductible is met.
Coverage for the first three pints of blood deductible.
Policies effective on or after June 1, 2010, provide coverage for Hospice Part A coinsurance.

Additional Benefits

Coverage for the Medicare Part A deductible ($1,632 per benefit period in 2024).
Coverage for the Medicare Part B deductible ($240 per calendar year in 2022).
Coverage for the skilled nursing facility care daily coinsurance amount ($204 per day for days 21-100 per benefit period in 2022).
Coverage for 100% of Medicare Part B excess charges. The Medicare Part B excess charge is the additional 15% a physician can charge if the claim is non-assigned.
80% coverage for medically necessary emergency care in a foreign country after a $250 calendar year deductible. The lifetime maximum benefit is $50,000.