Medicare Comparison Chart

• Inpatient hospital care
• Skilled nursing facilities (excluding long-term care)
• Hospice
• Some healthcare

• Doctors’ visits and most medically necessary doctors’ services
• Outpatient hospital care
• Durable medical equipment (DME)
• Prescription drugs that require DME to administer
• Preventative care
• X-rays & lab tests
• Mental health care

PH-Specific Coverage

• Tyvaso®
• Flolan®, Veletri® or generic epoprostenol
• Remodulin®
• Ventavis®
• DME (e.g., home oxygen)
• Pulmonary rehabilitation (PR)
  * You may be limited to 36 PR sessions per lifetime

• Allows members the option to select a privately managed care plan to replace original Medicare and its benefits.
• Plans must provide all Part A & B services (may provide additional coverage), but may do so with different rules, costs and restrictions.
• Part C is not a separate benefit.

• Optional outpatient prescription drug coverage provided through private insurance companies.
• Buying into Part D depends on your personal drug needs.

PH-Specific Coverage

• Tracleer®
• Letairis®
• Adcirca®
• Revatio®/Viagra®
• Opsumit®
• Adempas®
• Orenitram®

Learn more about choosing a plan that meets your needs

• No premium
  Part A is free if you or your spouse have worked and paid Social Security taxes for at least 10 years.You will pay a monthly premium if you have worked and paid taxes for less than 10 years.

Part A Cost Breakdown 2016

• Monthly premium ($121.80)
• Annual deductible ($166)
• Coinsurance/ copayments

Part B Cost Breakdown 2016

• Varies from plan to plan

• Varies from plan to plan.
  In 2016, your annual deductible cannot be more than $360. Average national premium is $34.10.
• Premiums and deductibles do not apply and copayments will be lower if you are enrolled in Extra Help – a federal program designed to help low-income individuals cover the cost of their prescription drugs.
• High out-of-pocket costs during the coverage gap until you reach a catastrophic limit.
• You may be charged an additional, permanent fee if you decline the Medicare Part D benefit when it is first offered to you and then later decide to purchase a Medicare Part D plan.

Part D Cost Breakdown 2016

Original Medicare does not cover everything. In addition to retirement options through employers, individuals eligible for Medicare have the choice of purchasing a Medigap (Medicare Supplement) policy that would help cover some of the gaps in Original Medicare’s coverage.

Depending on where you live, there are ten standard Medigap plans, A-N.* Plan A is generally the cheapest (offering the least amount of additional benefits) and Plan L the most expensive (offering more benefits). However, coverage and premiums vary among plans depending on the company you buy it from.

*As of June 1, 2010, Medicare introduced two new plans, M and N. Plans E, H, I and J will no longer be offered, but Medicare consumers who already have these plans will be able to keep them.