Upload Final Medigap - Medigap Generic Plan Details - Medigap Generic Plan Details CSV.csv

Final Medigap - Medigap Generic Plan Details - Medigap Generic Plan Details CSV.csv

@@ -0,0 +1,338 @@
+plan_type,part_type,service_name,no_of_days,amount_paid_by_medicare,amount_paid_by_plan,amount_paid_by_customer
+A,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",$0}"
+A,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+A,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+A,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",$0}","{""$240 (Part B Deductible)"",$0,""All Costs""}"
+A,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+A,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{$0,""$408 a Day"",""$816 a Day"",""100% of Additional Expenses"",$0}","{""$1632 (Part A Deductible)"",$0,$0,$0,""All Costs""}"
+A,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""All but very limited copayment / coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment / coinsurance""}",{$0}
+A,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,$0,$0}","{$0,""Up to $204 a Day"",""All Costs""}"
+A,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+B,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""Pays Copayments and Coinsurance""}",{$0}
+B,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+B,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,""Up to $204 a Day"",""All Costs""}"
+B,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+B,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+B,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+B,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",$0}"
+B,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",$0}","{""$240 (Part B Deductible)"",$0,""All Costs""}"
+B,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Additional Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+C,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+C,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+C,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{""$240 (Part B deductible)"",20%}","{$0,$0}"
+C,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+C,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+C,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""Pays Copayments and Coinsurance""}",{$0}
+C,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+C,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Additional Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+C,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{""$240 (Part B Deductible)"",""Generally 20%"",$0}","{$0,$0,""All Costs""}"
+C,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$240 (Part B Deductible)"",""Generally 20%""}","{$0,$0,$0}"
+D,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",$0}","{""$240 (Part B Deductible)"",$0,""All Costs""}"
+D,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+D,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+D,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+D,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+D,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+D,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+D,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""All but very limited copayment / coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment / coinsurance""}",{$0}
+D,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+D,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",$0}"
+F,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{""$240 (Part B deductible)"",20%}","{$0,$0}"
+F,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+F,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$240 (Part B Deductible)"",""Generally 20%""}","{$0,$0,$0}"
+F,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{""$240 (Part B Deductible)"",""Generally 20%"",100%}","{$0,$0,$0}"
+F,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+F,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+F,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+F,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+F,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+F,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""All but very limited copayment / coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment / coinsurance""}",{$0}
+G,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""All but very limited copayment / coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment / coinsurance""}",{$0}
+G,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+G,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+G,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+G,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+G,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",100%}","{""$240 (Part B Deductible)"",$0,$0}"
+G,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+G,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+G,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",$0}"
+G,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+HDF,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$240 (Part B Deductible)"",""Generally 20%""}","{$0,$0,$0}"
+HDF,deductible,,,,,
+HDF,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+HDF,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+HDF,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+HDF,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+HDF,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{""$240 (Part B deductible)"",20%}","{$0,$0}"
+HDF,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+HDF,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""Pays Copayments and Coinsurance""}",{$0}
+HDF,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{""$240 (Part B Deductible)"",""Generally 20%"",100%}","{$0,$0,$0}"
+HDF,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+HDG,Other Benefits,Foreign Travel,"{""1st $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% up to a lifetime maximum benefit of $50,000""}","{$250,""20% and amounts over the $50,000 lifetime maximum benefit""}"
+HDG,deductible,,,,,
+HDG,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+HDG,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Unless Part B deductible has been met)"",$0}"
+HDG,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+HDG,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+HDG,Part B,Blood,"{""First Three Pints"",""Next $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$0,$0,80%}","{""All costs"",$0,20%}","{$0,""$240 (Unless Part B deductible has been met)"",$0}"
+HDG,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",100%}","{""$240(Unless Part B deductible has been met)"",$0,$0}"
+HDG,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+HDG,Part A,Hospice Care,"{""Must Meet Medicare's Requirements, including a doctor's certification of terminal illness""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""Pays Copayments and Coinsurance""}",{$0}
+HDG,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+K,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+K,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $100 a Day (50%)"",$0}","{$0,""Up to $100 a Day (50%)"",""All Costs""}"
+K,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{50%,$0,""Generally 10%""}","{50%,""$240 (Part B Deductible)"",""Generally 10%""}"
+K,Part A,-Plan Notes-,"{""Annual out-of-pocket limit""}",{$0},{$0},"{""Up to $7060""}"
+K,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$816 (50% of Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$816 (50% of Deductible)"",$0,$0,$0,""All Costs""}"
+K,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+K,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,10%}","{""$240 (Part B deductible)"",10%}"
+K,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""50% of Copayments and Coinsurance""}","{""50% of Copayments and Coinsurance""}"
+K,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{50%,$0}","{50%,$0}"
+K,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Preventative Benefits"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 75%"",""Generally 80%"",$0}","{$0,""Remainder of Approved Costs"",""Generally 10%"",$0}","{""$240 (Part B Deductible)"",""All Costs Above Approved Costs"",""Generally 10%"",""All Costs (NA to Max Out of Pocket""}"
+L,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{75%,$0}","{25%,$0}"
+L,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""75% of Copayments and Coinsurance""}","{""25% of Copayments and Coinsurance""}"
+L,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Preventative Benefits"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 75%"",""Generally 80%"",$0}","{$0,""Remainder of Approved Costs"",""Generally 15%"",$0}","{""$240 (Part B Deductible)"",""All Costs Above Approved Costs"",""Generally 5%"",""All Costs (NA to Max Out of Pocket""}"
+L,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+L,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{75%,$0,""Generally 15%""}","{25%,""$240 (Part B Deductible)"",""Generally 5%""}"
+L,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+L,Part A,-Plan Notes-,"{""Annual out-of-pocket limit""}",{$0},{$0},"{""Up to $3530""}"
+L,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1224 (75% of Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$408 (25% of Deductible)"",$0,$0,$0,""All Costs""}"
+L,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,15%}","{""$240 (Part B deductible)"",5%}"
+L,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $153 a Day (75%)"",$0}","{$0,""Up to $51 a Day (25%)"",""All Costs""}"
+M,Part A,Hospice Care,"{""Must Meet Medicare's Requirements""}","{""All but very limited coinsurance, coinsurance for outpatient drugs and inpatient respite care.""}","{""Pays Copayments and Coinsurance""}",{$0}
+M,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+M,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+M,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+M,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",0%}"
+M,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+M,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{10%,$0}","{$0,$0}"
+M,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+M,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$816 (50% of Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$816 (50% of Deductible)"",$0,$0,$0,""All Costs""}"
+M,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Generally 20%"",$0}","{""$240 (Part B Deductible)"",$0,""All Costs""}"
+MA_CORE,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary skilled care services and medical supplies""}",{100%},{$0},{$204}
+MA_CORE,Part B,Special Medical Formulas Mandated by Law (Covered by Medicare),"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+MA_CORE,Part B,Clinical Laboratory Services,"{""Blood Tests for diagnostic services""}",{100%},{$0},{$0}
+MA_CORE,Part B,Medical expenses in or out of the Hospital and outpatient Hospital treatment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,""Generally 80%""}","{$0,""Generally 20%""}","{""$240 (Part B Deductible)"",$0}"
+MA_CORE,Part A,Licensed Mental Hospital,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after of a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All but $1632"",$0,$0,$0,$0}","{$0,""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",$0}","{""$1632 (Part A Deductible)"",$0,$0,$0,""All Costs""}"
+MA_CORE,Part A,Hospitalization,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All but $1632"",""All but $408 a day"",""All but $816 a day"",$0,$0}","{$0,""$408 a day"",""$816 a day"",100%,$0}","{""$1632 (Part A Deductible)"",$0,$0,$0,""All Costs""}"
+MA_CORE,Part B,Blood,"{""First three pints"",""Next $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,$0,80%}","{100%,$0,20%}","{$0,""$240 (Part B Deductible)"",$0}"
+MA_CORE,Part B,Outpatient treatment for other mental health disorders,"{""First 24 visits per calendar year"",""Visits 25 and after""}","{$0,$0}","{100%,$0}","{$0,""All Costs""}"
+MA_CORE,Part B,Outpatient treatment for biologically-based mental disorders,"{""First $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts""}","{$0,50%}","{$0,50%}","{""$240 (Part B Deductible)"",$0}"
+MA_CORE,Part A,Skilled Nursing Facility Care,"{""First 20 days"",""21st through 100th day"",""101st day and after""}","{""All Approved Amounts"",""All but $204 a day"",$0}","{$0,$0,$0}","{$0,$204,""All Costs""}"
+MA_CORE,Part A,Hospice Care,"{""Hospice Care available as long as your doctor certifies you are terminally ill and you elect to receive these services""}","{""All but very limited coinsurance for outpatient drugs and inpatient respite care""}",{Coinsurance},{$0}
+MA_CORE,Part A,Licensed Mental Hospital Stays,"{""First 60 days per calendar year unless days covered by Medicare or already covered by the Plan in that calendar year for other mental disorders"",""61st through 120th day of a Benefit Period"",""Days after 60 days per calendar year less days covered by Medicare or plan in that calendar year""}","{$0,$0,$0}","{""All but $1632"",""100% of Medicare eligible expenses"",$0}","{""$1632 (Part A Deductible)"",$0,""All Costs""}"
+MA_CORE,Part B,Special Medical Formulas Mandated by Law (Not covered by Medicare),"{""""}",{$0},"{""All allowed charges""}","{""Remaining costs""}"
+MA_CORE,Other,Plan Details,"{""Outpatient Prescription Drugs Not Covered by Medicare"",""Fitness Program Not Covered by Medicare""}","{$0,$0}","{$0,$150}","{""All Costs"",""All charges after $150""}"
+MA_CORE,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+MA_SUPP1,Part B,Special Medical Formulas Mandated by Law (Covered by Medicare),"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{""$240 (Part B Deductible)"",20%}","{$0,$0}"
+MA_SUPP1,Other,Plan Details,"{""Only the services listed in this plan while traveling outside the United States"",""Outpatient Prescription Drugs Not Covered by Medicare"",""Fitness Program Not Covered by Medicare""}","{$0,$0,$0}","{""Remainder of charges (including portion normally paid by Medicare)"",$0,$150}","{$0,""All Costs"",""All charges after $150""}"
+MA_SUPP1,Part B,Clinical Laboratory Services,"{""Blood Tests for diagnostic services""}",{100%},{$0},{$0}
+MA_SUPP1,Part B,Medical expenses in or out of the Hospital and outpatient Hospital treatment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,""Generally 80%""}","{""$240 (Part B Deductible)"",""Generally 20%""}","{$0,$0}"
+MA_SUPP1,Part A,Licensed Mental Hospital,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after of a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All but $1632"",$0,$0,$0,$0}","{""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+MA_SUPP1,Part A,Skilled Nursing Facility Care,"{""First 20 days"",""21st through 100th day"",""101st day through 365th day of a Benefit Period"",""Beyond the 365th day of a Benefit Period""}","{""All Approved Amounts"",""All but $204 a day"",$0,$0}","{$0,""$204 a day"",$10,$0}","{$0,$0,Balance,""All Costs""}"
+MA_SUPP1,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{""$240 (Part B Deductible)"",20%}","{$0,$0}"
+MA_SUPP1,Part B,Outpatient treatment for biologically-based mental disorders,"{""First $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts""}","{$0,50%}","{""$240 (Part B Deductible)"",50%}","{$0,$0}"
+MA_SUPP1,Part A,Blood,"{""First three pints"",""Additional amounts""}","{$0,100%}","{""Three pints"",$0}","{$0,$0}"
+MA_SUPP1,Part B,Blood,"{""First three pints"",""Next $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,$0,80%}","{100%,""$240 (Part B Deductible)"",20%}","{$0,$0,$0}"
+MA_SUPP1,Part B,Outpatient treatment for other mental health disorders,"{""First 24 visits per calendar year"",""Visits 25 and after""}","{$0,$0}","{100%,$0}","{$0,""All Costs""}"
+MA_SUPP1,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+MA_SUPP1,Part A,Hospitalization,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All but $1632"",""All but $408 a day"",""All but $816 a day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a day"",""$816 a day"",100%,$0}","{$0,$0,$0,$0,""All Costs""}"
+MA_SUPP1,Part B,Special Medical Formulas Mandated by Law (Not covered by Medicare),"{""""}",{$0},"{""All allowed charges""}","{""Remaining costs""}"
+MA_SUPP1,Part A,Hospice Care,"{""Hospice Care available as long as your doctor certifies you are terminally ill and you elect to receive these services""}","{""All but very limited coinsurance for outpatient drugs and inpatient respite care""}",{Coinsurance},{$0}
+MA_SUPP1,Part A,Licensed Mental Hospital Stays,"{""First 60 days per calendar year unless days covered by Medicare or already covered by the Plan in that calendar year for other mental disorders"",""61st through 120th day of a Benefit Period"",""Days after 60 days per calendar year less days covered by Medicare or plan in that calendar year""}","{$0,$0,$0}","{""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",$0}","{$0,$0,""All Costs""}"
+MA_SUPP1A,Part B,Special Medical Formulas Mandated by Law (Not covered by Medicare),"{""""}",{$0},"{""All allowed charges""}","{""Remaining costs""}"
+MA_SUPP1A,Part A,Hospice Care,"{""Hospice Care available as long as your doctor certifies you are terminally ill and you elect to receive these services""}","{""All but very limited coinsurance for outpatient drugs and inpatient respite care""}",{Coinsurance},{$0}
+MA_SUPP1A,Part B,Blood,"{""First three pints"",""Next $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,$0,80%}","{""All Costs"",$0,20%}","{$0,""$240 (Part B Deductible)"",$0}"
+MA_SUPP1A,Part A,Skilled Nursing Facility Care,"{""First 20 days"",""21st through 100th day"",""101st day through 365th day of a Benefit Period"",""Beyond the 365th day of a Benefit Period""}","{""All Approved Amounts"",""All but $204 a day"",$0,$0}","{$0,""$204 a day"",""$10 a day"",$0}","{$0,$0,Balance,""All Costs""}"
+MA_SUPP1A,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+MA_SUPP1A,Other,Plan Details,"{""Only the services listed in this plan while traveling outside the United States"",""Outpatient Prescription Drugs Not Covered by Medicare"",""Fitness Program Not Covered by Medicare""}","{$0,$0,$0}","{""Remainder of charges (including portion normally paid by Medicare)"",$0,$150}","{$0,""All Costs"",""All charges after $150""}"
+MA_SUPP1A,Part B,Outpatient treatment for other mental health disorders,"{""First 24 visits per calendar year"",""Visits 25 and after""}","{$0,$0}","{100%,$0}","{$0,""All Costs""}"
+MA_SUPP1A,Part A,Licensed Mental Hospital,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after of a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{$0,$0,$0,$0,$0}","{""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+MA_SUPP1A,Part B,Clinical Laboratory Services,"{""Blood Tests for diagnostic services""}",{100%},{$0},{$0}
+MA_SUPP1A,Part A,Hospitalization,"{""First 60 days of a Benefit Period"",""61st through 90th day of a Benefit Period"",""91st day and after a Benefit Period (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All but $1632"",""All but $408 a day"",""All but $816 a day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a day"",""$816 a day"",100%,$0}","{$0,$0,$0,$0,""All Costs""}"
+MA_SUPP1A,Part B,Outpatient treatment for biologically-based mental disorders,"{""First $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+MA_SUPP1A,Part A,Licensed Mental Hospital Stays,"{""First 60 days per calendar year unless days covered by Medicare or already covered by the Plan in that calendar year for other mental disorders"",""61st through 120th day of a Benefit Period"",""Days after 60 days per calendar year less days covered by Medicare or plan in that calendar year""}","{$0,$0,$0}","{""100% of Medicare eligible expenses"",""100% of Medicare eligible expenses"",$0}","{$0,$0,""All Costs""}"
+MA_SUPP1A,Part B,Special Medical Formulas Mandated by Law (Covered by Medicare),"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+MA_SUPP1A,Part A,Blood,"{""First three pints"",""Additional amounts""}","{$0,100%}","{""Three pints"",$0}","{$0,$0}"
+MA_SUPP1A,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+MA_SUPP1A,Part B,Medical expenses in or out of the Hospital and outpatient Hospital treatment,"{""First $240 of Medicare Approved amounts"",""Remainder of Medicare Approved amounts""}","{$0,""Generally 80%""}","{$0,""Generally 20%""}","{""$240 (Part B Deductible)"",$0}"
+MN_50,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$0 or $240 (Optional Part B Rider)"",20%}","{$0,""$240 or $0 (Optional Part B Rider)"",$0}"
+MN_50,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$0 or $1632 (Optional Part A Deductible Rider)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0}"
+MN_50,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_50,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_50,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_50,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{""$0 or $240 (Optional Part B Rider)"",20%}","{""$240 or $0 (Part B Rider)"",$0}"
+MN_50,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_50,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{""$0 or $120 (Preventative Care Rider)"",$0}","{""All Costs or $0 (Preventative Care Rider)"",""All Costs""}"
+MN_50,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$0 or $240 (Optional Part B Deductible Rider)"",20%,""$0 or 100% (Optional Part B Excess Rider)""}","{""$240 or $0 (Part B Deductible)"",$0,""All Costs or $0 (Part B Excess Rider)""}"
+MN_50,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_50,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_75,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{""$0 or $120 (Preventative Care Rider)"",$0}","{""All Costs or $0 (Preventative Care Rider)"",""All Costs""}"
+MN_75,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_75,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_75,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{""$0 or $240 (Optional Part B Rider)"",20%}","{""$240 or $0 (Part B Rider)"",$0}"
+MN_75,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$0 or $240 (Optional Part B Rider)"",20%}","{$0,""$240 or $0 (Optional Part B Rider)"",$0}"
+MN_75,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$0 or $1632 (Optional Part A Deductible Rider)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0}"
+MN_75,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_75,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_75,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_75,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$0 or $240 (Optional Part B Deductible Rider)"",20%,""$0 or 100% (Optional Part B Excess Rider)""}","{""$240 or $0 (Part B Deductible)"",$0,""All Costs or $0 (Part B Excess Rider)""}"
+MN_75,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_A50,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{""$0 or $240 (Optional Part B Rider)"",20%}","{""$240 or $0 (Part B Rider)"",$0}"
+MN_A50,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$0 or $240 (Optional Part B Rider)"",20%}","{$0,""$240 or $0 (Optional Part B Rider)"",$0}"
+MN_A50,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$0 or $1632 (Optional Part A Deductible Rider)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0}"
+MN_A50,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_A50,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_A50,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{""$0 or $120 (Preventative Care Rider)"",$0}","{""All Costs or $0 (Preventative Care Rider)"",""All Costs""}"
+MN_A50,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_A50,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_A50,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_A50,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_A50,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$0 or $240 (Optional Part B Deductible Rider)"",20%,""$0 or 100% (Optional Part B Excess Rider)""}","{""$240 or $0 (Part B Deductible)"",$0,""All Costs or $0 (Part B Excess Rider)""}"
+MN_BASIC,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$0 or $240 (Optional Part B Deductible Rider)"",20%,""$0 or 100% (Optional Part B Excess Rider)""}","{""$240 or $0 (Part B Deductible)"",$0,""All Costs or $0 (Part B Excess Rider)""}"
+MN_BASIC,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_BASIC,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_BASIC,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{""$0 or $240 (Optional Part B Rider)"",20%}","{""$240 or $0 (Part B Rider)"",$0}"
+MN_BASIC,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_BASIC,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_BASIC,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$0 or $1632 (Optional Part A Deductible Rider)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0}"
+MN_BASIC,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{""$0 or $120 (Preventative Care Rider)"",$0}","{""All Costs or $0 (Preventative Care Rider)"",""All Costs""}"
+MN_BASIC,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$0 or $240 (Optional Part B Rider)"",20%}","{$0,""$240 or $0 (Optional Part B Rider)"",$0}"
+MN_BASIC,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_BASIC,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_EXTB,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Medicare copayment/coinsurance""}",{$0}
+MN_EXTB,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,$240,20%}","{$0,$0,$0}"
+MN_EXTB,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",""80% of covered expenses up to 120 days per calendar year""}","{$0,$0,""Remaining Costs""}"
+MN_EXTB,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+MN_EXTB,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_EXTB,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_EXTB,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$240 (Part B Deductible)"",20%,100%}","{$0,$0,$0}"
+MN_EXTB,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$0,80%}","{""$240 (Part B Deductible)"",20%}","{$0,$0}"
+MN_EXTB,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{$120,$0}","{$0,""All Costs""}"
+MN_EXTB,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_EXTB,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{$0,$0,$0,$0}"
+MN_HDED,Part B,Home Health Care,"{""Medically necessary skilled care services and medical supplies"",""Durable medical equipment First $240 of Medicare-approved amounts"",""   Remainder of medicare approved amounts""}","{100%,$0,80%}","{$0,$0,20%}","{$0,""$240 (Part B Deductible)"",$0}"
+MN_HDED,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment/coinsurance""}",{$0}
+MN_HDED,deductible,,,,,
+MN_HDED,Additional,Foreign Travel,"{""Medically necessary emergency care services beginning during travel outside the USA""}",{$0},"{""100% of covered services""}","{""Expenses not paid by Medicare or the policy""}"
+MN_HDED,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+MN_HDED,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+MN_HDED,Additional,Preventative Medical Care Benefit,"{""Up to $120 each calendar year for routine annual medical exam, including diagnostic X-rays and laboratory services"",""Immunizations not otherwise covered under Part D and routine screenings for cancer""}","{$0,$0}","{$120,100%}","{Balance,$0}"
+MN_HDED,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+MN_HDED,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After"",""121st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0,$0}","{$0,""Up to $204 a Day"",80%,$0}","{$0,$0,20%,""All Costs""}"
+MN_HDED,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,""Generally 80%""}","{$0,""Generally 20%""}","{""$240 (Part B Deductible)"",$0}"
+MN_HDED,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible) "",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+MN_HDED,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B deductible)"",$0}"
+MN_HDED2,Additional,Preventative Medical Care Benefit,"{""Up to $120 each calendar year for routine annual medical exam, including diagnostic X-rays and laboratory services"",""Immunizations not otherwise covered under Part D and routine screenings for cancer""}","{$0,$0}","{$120,100%}","{Balance,$0}"
+MN_HDED2,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After"",""121st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0,$0}","{$0,""Up to $204 a Day"",80%,$0}","{$0,$0,20%,""All Costs""}"
+MN_HDED2,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+MN_HDED2,deductible
+MN_HDED2,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible) "",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+MN_HDED2,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+MN_HDED2,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment/coinsurance""}",{$0}
+MN_HDED2,Additional,Foreign Travel,"{""Medically necessary emergency care services beginning during travel outside the USA""}",{$0},"{""100% of covered services""}","{""Expenses not paid by Medicare or the policy""}"
+MN_PBCO,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_PBCO,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,$0,20%}","{$0,$240,$0}"
+MN_PBCO,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_PBCO,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{$0,20%}","{$240,$0}"
+MN_PBCO,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_PBCO,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{$0,$0}","{""All Costs"",""All Costs""}"
+MN_PBCO,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{$1632,""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{$0,$0,$0,$0}"
+MN_PBCO,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_PBCO,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_PBCO,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{$0,20%,$0}","{$240,$0,""All Costs""}"
+MN_PBCO,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_XBAS,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$0 or $1632 (Optional Part A Deductible Rider)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0}"
+MN_XBAS,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",$0}","{$0,$0,""All Costs""}"
+MN_XBAS,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_XBAS,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$240,80%}","{""$0 or $240 (Optional Part B Rider)"",20%}","{""$240 or $0 (Part B Rider)"",$0}"
+MN_XBAS,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Remaining costs""}",{$0}
+MN_XBAS,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$0 or $240 (Optional Part B Rider)"",20%}","{$0,""$240 or $0 (Optional Part B Rider)"",$0}"
+MN_XBAS,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{""$0 or $240 (Optional Part B Deductible Rider)"",20%,""$0 or 100% (Optional Part B Excess Rider)""}","{""$240 or $0 (Part B Deductible)"",$0,""All Costs or $0 (Part B Excess Rider)""}"
+MN_XBAS,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{""$0 or $120 (Preventative Care Rider)"",$0}","{""All Costs or $0 (Preventative Care Rider)"",""All Costs""}"
+MN_XBAS,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},"{""100% of any remaining Medicare eligible expenses""}",{$0}
+MN_XBAS,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_XBAS,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_XBAS2,Parts A & B,Home Health Care & Medicare Approved Services,"{""Medically Necessary Skilled Care Services and Medical Supplies""}",{100%},{$0},{$0}
+MN_XBAS2,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{""3 Pints"",$0}","{$0,$0}"
+MN_XBAS2,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+MN_XBAS2,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,$0,20%}","{$0,""$240 (Part B Deductible)"",$0}"
+MN_XBAS2,Parts A & B,Preventative Medical Care Benefit,"{""First $120 each calendar year"",""Additional Charges""}","{$0,$0}","{$120,$0}","{$0,""All Costs""}"
+MN_XBAS2,Part B,Medical Expenses,"{""1st $240 of Medicare Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge (above Medicare Approved Amounts)""}","{$0,80%,$0}","{$0,20%,100%}","{""$240 (Part B Deductible)"",$0,$0}"
+MN_XBAS2,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""Beyond the Additional 150 Days""}","{""All but $1632 Deductible"",""All But $408 a Day"",""All But $816 a Day"",$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Medicare Eligible Expenses""}","{$0,$0,$0,$0}"
+MN_XBAS2,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""$204 a Day"",""80% of covered expenses up to 120 days per calendar year""}","{$0,$0,""Remaining Costs""}"
+MN_XBAS2,Parts A & B,Emergency Foreign Travel Care,"{""Only the services listed above while traveling outside of the United States""}",{$0},"{""80% of covered expenses""}","{""Remaining Costs""}"
+MN_XBAS2,Part A,Hospice Care,"{""""}","{""All but very limited coinsurance for inpatient respite care.""}","{""Medicare copayment/coinsurance""}",{$0}
+MN_XBAS2,Parts A & B,Durable Medical Equipment,"{""First $240 of Medicare Approved Amounts"",""Remainder of Medicare Approved Amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B Deductible)"",$0}"
+N,Parts A & B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}",{100%},{$0},{$0}
+N,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts"",""Part B Excess Charge""}","{$0,""Generally 80%"",$0}","{$0,""Balance, Other than Copays"",$0}","{""$240 (Part B Deductible)"",""Up to $20/$50 Copays, Emergency visit copay waived if admitted"",""All Costs""}"
+N,Parts A & B,Durable Medical Equipment,"{""1st $240 of Medicare approved amounts"",""Remainder of medicare approved amounts""}","{$0,80%}","{$0,20%}","{""$240 (Part B deductible)"",0%}"
+N,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""All but very limited copayment / coinsurance for outpatient drugs and inpatient respite care""}","{""Medicare copayment / coinsurance""}",{$0}
+N,Other Benefits,Foreign Travel,"{""First $250 each calendar year"",""Remainder of Charges""}","{$0,$0}","{$0,""80% to a lifetime maximum of $50,000""}","{$250,""20% until the lifetime maximum, then all costs.""}"
+N,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+N,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$1632 (Part A Deductible)"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{$0,$0,$0,$0,""All Costs""}"
+N,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+N,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,$0,""Generally 20%""}","{$0,""$240 (Part B Deductible)"",$0}"
+N,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+WI_50,Part B,Preventative Medical Care Benefit,"{""Coverage for preventive health $0 care services not covered by Medicare and as determined to be medically appropriate by an attending physician""}",{$0},{80%},{20%}
+WI_50,Riders,Optional Riders,"{""Part A Deductible"",""365 Home Health Care Visits"",""Part B Deductible"",""Part B Copayment/Coinsurance"",""Part B Excess Charges"",""Foreign Travel Emergency Rider""}","{$0,""100% of charges for visits considered medically necessary by Medicare"",$0,""Generally 80%, after that Part B Deductible has been met."",$0,$0}","{""100% of Part A Deductible"",""An aggregate of 365 visits per year including those covered by Medicare"",""100% of Part B Deductible"",""Coverage of the Medicare Part B medical coinsurance, subject to a copayment or coinsurance of no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waived and the emergency visit is covered as a Medicare Part A expense."",""Difference between what Medicare pays and the amount charged by the provider, up to the limiting charge allowed by Medicare."",""After a separate Foreign Travel Emergency Rider deductible of $250, covers 80% of expenses associated with emergency medical care received outside the U.S.A. during the first 60 days of a trip with a lifetime maximum of $50,000 in covered expenses""}","{$0,""Charges for visits beyond 365 per year"",$0,""$240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waved and the emergency visit is covered as a Medicare Part A expense."",$0,""$250, Then 20% of charges for the first 60 Days up to the $50,000 Lifetime maximum; 100% beyond 60 Days or over $50,000 maximum""}"
+WI_50,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+WI_50,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+WI_50,Additional,Kidney Disease Care,"{""Inpatient and outpatient expenses for dialysis, transplantation or donor-related services""}",{80%},"{""Up to $30,000 per year""}","{""Charges in excess of $30,000""}"
+WI_50,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""Generally 80%""}","{""$240 (Part B deductible) or $0 or $240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit"",""Generally 20% or Optional Part B Excess Charges Rider""}","{""$240 (Part B Deductible)"",""Charges in excess of Medicare approved charges or charges not paid by Medicare or $0""}"
+WI_50,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+WI_50,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""20% or Optional Part B Excess Charges Rider""}","{$0,""$240 (Part B deductible) or $0"",$0}"
+WI_50,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$0  or Optional Part A Deductible Rider"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0,""All Costs""}"
+WI_50,Part B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}","{""100% of charges for visits considered medically necessary by Medicare""}","{""40 visits in addition to those paid by Medicare or Optional Additional Home Health Rider""}","{""Beyond 40 visits per calendar year or Beyond 365 visits""}"
+WI_50,Additional,Licensed Skilled Nursing Facility Care,"{""The facility does not have to be certified by Medicare, no prior hospitalization is required and the stay does not have to meet Medicare's definition""}","{""$0 for services beyond those covered under Part A""}","{""Up to 30 days per admission for medically necessary care""}","{""Charges for care beyond 30 days per admission of skilled care.""}"
+WI_50,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+WI_50,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited $0 or 100% of copayment/ $0 copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""$0 or 100% of copayment/coinsurance""}",{$0}
+WI_50,Additional,Chiropractic Services,"{""""}","{""80% for manual manipulations of the spine to correct a subluxation that can be demonstrated by X-ray""}","{""The full usual, customary and reasonable charge, less what Medicare pays for Medicare- eligible expenses""}","{""Charges in excess of the full, usual, customary and reasonable charge""}"
+WI_50,Additional,Diabetic Equipment & Supplies,"{""Self-education programs and infusion pump (provided you use it for 30 days before buying it)""}","{""Medicare generally does not cover diabetic supplies""}","{""The full usual, customary and reasonable charge, less what Medicare paid""}","{""Charges in excess of the full usual, customary and reasonable charge""}"
+WI_75,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""20% or Optional Part B Excess Charges Rider""}","{$0,""$240 (Part B deductible) or $0"",$0}"
+WI_75,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited $0 or 100% of copayment/ $0 copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""$0 or 100% of copayment/coinsurance""}",{$0}
+WI_75,Additional,Diabetic Equipment & Supplies,"{""Self-education programs and infusion pump (provided you use it for 30 days before buying it)""}","{""Medicare generally does not cover diabetic supplies""}","{""The full usual, customary and reasonable charge, less what Medicare paid""}","{""Charges in excess of the full usual, customary and reasonable charge""}"
+WI_75,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""Generally 80%""}","{""$240 (Part B deductible) or $0 or $240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit"",""Generally 20% or Optional Part B Excess Charges Rider""}","{""$240 (Part B Deductible)"",""Charges in excess of Medicare approved charges or charges not paid by Medicare or $0""}"
+WI_75,Riders,Optional Riders,"{""Part A Deductible"",""365 Home Health Care Visits"",""Part B Deductible"",""Part B Copayment/Coinsurance"",""Part B Excess Charges"",""Foreign Travel Emergency Rider""}","{$0,""100% of charges for visits considered medically necessary by Medicare"",$0,""Generally 80%, after that Part B Deductible has been met."",$0,$0}","{""100% of Part A Deductible"",""An aggregate of 365 visits per year including those covered by Medicare"",""100% of Part B Deductible"",""Coverage of the Medicare Part B medical coinsurance, subject to a copayment or coinsurance of no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waived and the emergency visit is covered as a Medicare Part A expense."",""Difference between what Medicare pays and the amount charged by the provider, up to the limiting charge allowed by Medicare."",""After a separate Foreign Travel Emergency Rider deductible of $250, covers 80% of expenses associated with emergency medical care received outside the U.S.A. during the first 60 days of a trip with a lifetime maximum of $50,000 in covered expenses""}","{$0,""Charges for visits beyond 365 per year"",$0,""$240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waved and the emergency visit is covered as a Medicare Part A expense."",$0,""$250, Then 20% of charges for the first 60 Days up to the $50,000 Lifetime maximum; 100% beyond 60 Days or over $50,000 maximum""}"
+WI_75,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+WI_75,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+WI_75,Part B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}","{""100% of charges for visits considered medically necessary by Medicare""}","{""40 visits in addition to those paid by Medicare or Optional Additional Home Health Rider""}","{""Beyond 40 visits per calendar year or Beyond 365 visits""}"
+WI_75,Additional,Chiropractic Services,"{""""}","{""80% for manual manipulations of the spine to correct a subluxation that can be demonstrated by X-ray""}","{""The full usual, customary and reasonable charge, less what Medicare pays for Medicare- eligible expenses""}","{""Charges in excess of the full, usual, customary and reasonable charge""}"
+WI_75,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+WI_75,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$0  or Optional Part A Deductible Rider"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0,""All Costs""}"
+WI_75,Part B,Preventative Medical Care Benefit,"{""Coverage for preventive health $0 care services not covered by Medicare and as determined to be medically appropriate by an attending physician""}",{$0},{80%},{20%}
+WI_75,Additional,Licensed Skilled Nursing Facility Care,"{""The facility does not have to be certified by Medicare, no prior hospitalization is required and the stay does not have to meet Medicare's definition""}","{""$0 for services beyond those covered under Part A""}","{""Up to 30 days per admission for medically necessary care""}","{""Charges for care beyond 30 days per admission of skilled care.""}"
+WI_75,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+WI_75,Additional,Kidney Disease Care,"{""Inpatient and outpatient expenses for dialysis, transplantation or donor-related services""}",{80%},"{""Up to $30,000 per year""}","{""Charges in excess of $30,000""}"
+WI_BASE,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+WI_BASE,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,80%}","{100%,""$240 (Part B Deductible)"",""(1) 20%, (2) or Optional Part B Excess Charges Rider, (3) or Optional Part B Copayment or Coinsurance Rider""}","{$0,$0,""(1) Charges in excess of Medicare-approved charges. (2) Charges not paid by Medicare or the policy. (3) Up to $20 per office visit and up to $50 per emergency room visit.""}"
+WI_BASE,Additional,Kidney Disease Care,"{""Inpatient and outpatient expenses for dialysis, transplantation or donor-related services""}",{80%},"{""Up to $30,000 per year""}","{""Charges in excess of $30,000""}"
+WI_BASE,Part B,Preventative Medical Care Benefit,"{""PREVENTATIVE MEDICAL CARE BENEFIT - NOT COVERED BY MEDICARE"",""Some annual physical and preventive tests and services administered or ordered by your doctor when not covered by Medicare."",""First $120 each calendar year"",""Additional Charges""}","{"""","""",$0,$0}","{"""","""",$120,""(1) $0, (2) or Optional Part B Excess Charges Rider, (3) or Optional Part B Copayment or Coinsurance Rider""}","{"""","""",$0,""(1) Charges in excess of Medicare-approved charges. (2) Charges not paid by Medicare or the policy. (3) Up to $20 per office visit and up to $50 per emergency room visit.""}"
+WI_BASE,Riders,Optional Riders,"{""Part A Deductible"",""365 Home Health Care Visits"",""Part B Deductible"",""Part B Copayment/Coinsurance"",""Part B Excess Charges"",""Foreign Travel Emergency Rider""}","{$0,""100% of charges for visits considered medically necessary by Medicare"",$0,""Generally 80%, after that Part B Deductible has been met."",$0,$0}","{""100% of Part A Deductible"",""An aggregate of 365 visits per year including those covered by Medicare"",""100% of Part B Deductible"",""Coverage of the Medicare Part B medical coinsurance, subject to a copayment or coinsurance of no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waived and the emergency visit is covered as a Medicare Part A expense."",""Difference between what Medicare pays and the amount charged by the provider, up to the limiting charge allowed by Medicare."",""After a separate Foreign Travel Emergency Rider deductible of $250, covers 80% of expenses associated with emergency medical care received outside the U.S.A. during the first 60 days of a trip with a lifetime maximum of $50,000 in covered expenses""}","{$0,""Charges for visits beyond 365 per year"",$0,""$240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waved and the emergency visit is covered as a Medicare Part A expense."",$0,""$250, Then 20% of charges for the first 60 Days up to the $50,000 Lifetime maximum; 100% beyond 60 Days or over $50,000 maximum""}"
+WI_BASE,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,""Generally 80%""}","{""$0 or Optional Part B Deductible Rider"",""(1) Generally 20%, (2) or Optional Part B Excess Charges Rider, (3) or Optional Part B Copayment or Coinsurance Rider""}","{""$240 (Part B Deductible) or $0"",""(1) Charges in excess of Medicare-approved charges. (2) Charges not paid by Medicare or the policy. (3) Up to $20 per office visit and up to $50 per emergency room visit.""}"
+WI_BASE,Additional,Licensed Skilled Nursing Facility Care,"{""The facility does not have to be certified by Medicare, no prior hospitalization is required and the stay does not have to meet Medicare's definition""}","{""$0 for services beyond those covered under Part A""}","{""Up to 30 days per admission for medically necessary care""}","{""Charges for care beyond 30 days per admission of skilled care.""}"
+WI_BASE,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+WI_BASE,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited $0 or 100% of copayment/ $0 copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""$0 or 100% of copayment/coinsurance""}",{$0}
+WI_BASE,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$0  or Optional Part A Deductible Rider"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0,""All Costs""}"
+WI_BASE,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+WI_BASE,Additional,Diabetic Equipment & Supplies,"{""Self-education programs and infusion pump (provided you use it for 30 days before buying it)""}","{""Medicare generally does not cover diabetic supplies""}","{""The full usual, customary and reasonable charge, less what Medicare paid""}","{""Charges in excess of the full usual, customary and reasonable charge""}"
+WI_BASE,Additional,Chiropractic Services,"{""""}","{""80% for manual manipulations of the spine to correct a subluxation that can be demonstrated by X-ray""}","{""The full usual, customary and reasonable charge, less what Medicare pays for Medicare- eligible expenses""}","{""Charges in excess of the full, usual, customary and reasonable charge""}"
+WI_BASE,Part B,Foreign Travel,"{""FOREIGN TRAVEL - NOT COVERED BY MEDICARE"",""Medically necessary emergency care services beginning during the first 60 days of each trip outside of the USA."",""First $250 each calendar year"",""Remainder of charges""}","{"""","""",$0,$0}","{"""","""",$0,""(1) $0 or,  (2) Optional Foreign Travel Emergency Rider** (80% to a lifetime maximum benefit of $50,000)""}","{"""","""",$250,""(1) All costs or, (2) 20% and amounts over the $50,000 lifetime maximum""}"
+WI_BASE,Part B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}","{""100% of charges for visits considered medically necessary by Medicare""}","{""40 visits in addition to those paid by Medicare or Optional Additional Home Health Rider""}","{""Beyond 40 visits per calendar year or Beyond 365 visits""}"
+WI_BASE,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+WI_HDED,Part A,Inpatient Psychiatric Care,"{""Inpatient psychiatric care in participating psychiatric hospital""}","{""190 days per lifetime""}","{""175 additional days per lifetime""}","{""Beyond 365 Days""}"
+WI_HDED,Part B,Medical Expenses,"{""1st $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""Generally 80%""}","{""240 (Part B deductible) or $0 or $240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit"",""Generally 20% or Optional Part B Excess Charges Rider""}","{""$240 (Part B Deductible)"",""Charges in excess of Medicare approved charges or charges not paid by Medicare or $0""}"
+WI_HDED,Additional,Licensed Skilled Nursing Facility Care,"{""The facility does not have to be certified by Medicare, no prior hospitalization is required and the stay does not have to meet Medicare's definition""}","{""$0 for services beyond those covered under Part A""}","{""Up to 30 days per admission for medically necessary care""}","{""Charges for care beyond 30 days per admission of skilled care.""}"
+WI_HDED,Part B,Preventative Medical Care Benefit,"{""Coverage for preventive health $0 care services not covered by Medicare and as determined to be medically appropriate by an attending physician""}",{$0},{80%},{20%}
+WI_HDED,Part B,Blood,"{""First Three Pints"",""Next $240 of Approved Amounts"",""Remainder of Approved Amounts""}","{$0,$0,""Generally 80%""}","{100%,""$0 or Optional Part B Deductible Rider or Optional Part B Copayment or Coinsurance Rider"",""20% or Optional Part B Excess Charges Rider""}","{$0,""$240 (Part B deductible) or $0"",$0}"
+WI_HDED,Riders,Optional Riders,"{""Part A Deductible"",""365 Home Health Care Visits"",""Part B Deductible"",""Part B Copayment/Coinsurance"",""Part B Excess Charges"",""Foreign Travel Emergency Rider""}","{$0,""100% of charges for visits considered medically necessary by Medicare"",$0,""Generally 80%, after that Part B Deductible has been met."",$0,$0}","{""100% of Part A Deductible"",""An aggregate of 365 visits per year including those covered by Medicare"",""100% of Part B Deductible"",""Coverage of the Medicare Part B medical coinsurance, subject to a copayment or coinsurance of no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waived and the emergency visit is covered as a Medicare Part A expense."",""Difference between what Medicare pays and the amount charged by the provider, up to the limiting charge allowed by Medicare."",""After a separate Foreign Travel Emergency Rider deductible of $250, covers 80% of expenses associated with emergency medical care received outside the U.S.A. during the first 60 days of a trip with a lifetime maximum of $50,000 in covered expenses""}","{$0,""Charges for visits beyond 365 per year"",$0,""$240 (Part B Deductible) and no more than $20 per office visit and no more than $50 per emergency room visit.  If admitted, the $50 is waved and the emergency visit is covered as a Medicare Part A expense."",$0,""$250, Then 20% of charges for the first 60 Days up to the $50,000 Lifetime maximum; 100% beyond 60 Days or over $50,000 maximum""}"
+WI_HDED,Part B,Clinical Laboratory Services,"{""Tests for Diagnostic Services""}",{100%},{$0},{$0}
+WI_HDED,deductible,,,,,
+WI_HDED,Part A,Blood,"{""First Three Pints"",""Additional Amounts""}","{$0,100%}","{100%,$0}","{$0,$0}"
+WI_HDED,Additional,Kidney Disease Care,"{""Inpatient and outpatient expenses for dialysis, transplantation or donor-related services""}",{80%},"{""Up to $30,000 per year""}","{""Charges in excess of $30,000""}"
+WI_HDED,Part A,Hospice Care,"{""You must meet Medicare's requirements, including a doctor's certification of terminal illness""}","{""	All but very limited $0 or 100% of copayment/ $0 copayment/coinsurance for outpatient drugs and inpatient respite care""}","{""$0 or 100% of copayment/coinsurance""}",{$0}
+WI_HDED,Part B,Home Health Care,"{""Medically necessary skilled care services and medical supplies""}","{""100% of charges for visits considered medically necessary by Medicare""}","{""40 visits in addition to those paid by Medicare or Optional Additional Home Health Rider""}","{""Beyond 40 visits per calendar year or Beyond 365 visits""}"
+WI_HDED,Additional,Diabetic Equipment & Supplies,"{""Self-education programs and infusion pump (provided you use it for 30 days before buying it)""}","{""Medicare generally does not cover diabetic supplies""}","{""The full usual, customary and reasonable charge, less what Medicare paid""}","{""Charges in excess of the full usual, customary and reasonable charge""}"
+WI_HDED,Additional,Chiropractic Services,"{""""}","{""80% for manual manipulations of the spine to correct a subluxation that can be demonstrated by X-ray""}","{""The full usual, customary and reasonable charge, less what Medicare pays for Medicare- eligible expenses""}","{""Charges in excess of the full, usual, customary and reasonable charge""}"
+WI_HDED,Part A,Skilled Nursing Facility Care,"{""First 20 Days"",""21st Through 100th Day"",""101st Day and After""}","{""All Approved Amounts"",""All But $204 a Day"",$0}","{$0,""Up to $204 a Day"",$0}","{$0,$0,""All Costs""}"
+WI_HDED,Part A,Hospitalization,"{""First 60 Days"",""61st Through 90th Day"",""91st Day and After (60 Reserve Days)"",""After Reserve (Additional 365 Days)"",""Beyond the Additional 365 Days""}","{""All But $1632"",""All But $408 a Day"",""All But $816 a Day"",$0,$0}","{""$0  or Optional Part A Deductible Rider"",""$408 a Day"",""$816 a Day"",""100% of Eligible Expenses"",$0}","{""$1632 or $0 (Optional Rider)"",$0,$0,$0,""All Costs""}"