Medicare Supplement Plan A

A Medicare Supplement plan from Indiana Farm Bureau Health Plans will help pay for many costs not covered by Medicare. Because people have different needs, circumstances, expectations and budgets, Indiana Farm Bureau Health Plans offers four Medicare Supplement plans. Each plan has varying levels of supplemental coverage.

The charts below outline the coverage of Medicare Supplement Plan A, which offers basic benefits only. This plan is ideal for those who want coverage for many coinsurance payments, but do not foresee using a lot of health care services.

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As long as you make premium payments on time and do not file claims with false or misleading information you'll have the security of Indiana Farm Bureau Health Plans' Medicare Supplement plan.

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If you are not 100 percent satisfied with your Indiana Farm Bureau Health Plans' Medicare Supplement plan, return the Evidence of Coverage to us within 30 days after you receive it and we will gladly refund any payments you have made (less any benefits provided.)

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Plan A Details

Note: The benefits and costs shown are for plans effective on or after January 1, 2024.

Plan A covers these basic benefits:

Hospitalization

Part A coinsurance plus coverage for 365 additional days after Medicare benefits end

Medical Expenses

Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services

Blood

First three pints blood each year

Hospice

Part A coinsurance

HOSPITALIZATION*

Semi-private room and board, general nursing and miscellaneous services and supplies.

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
First 60 Days	MEDICARE PAYS All but $1,632	PLAN A PAYS $0	YOU PAY $1,632 info Part A deductible.
61st through 90th day	MEDICARE PAYS All but $408 a day	PLAN A PAYS $408 a day	YOU PAY $0
91st day and after: -While using 60 lifetime reserve days	MEDICARE PAYS All but $816 a day	PLAN A PAYS $816 a day	YOU PAY $0
Once lifetime reserve days are used: -Additional 365 days	MEDICARE PAYS $0	PLAN A PAYS 100% of Medicare eligible expenses	YOU PAY $0**
-Beyond additional 365 days	MEDICARE PAYS $0	PLAN A PAYS $0	YOU PAY All costs

SKILLED NURSING FACILITY CARE

You must meet Medicare’s requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving hospital.

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
First 20 Days	MEDICARE PAYS All approved amounts	PLAN A PAYS $0	YOU PAY $0
21st through 100th day	MEDICARE PAYS All but $204 a day	PLAN A PAYS $0	YOU PAY Up to $204 a day
101st day and after	MEDICARE PAYS $0	PLAN A PAYS $0	YOU PAY All costs

BLOOD

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
First 3 pints	MEDICARE PAYS $0	PLAN A PAYS All costs	YOU PAY $0
Remainder of Medicare-approved amounts	MEDICARE PAYS 100%	PLAN A PAYS $0	YOU PAY $0

HOSPICE CARE

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
You must meet Medicare’s requirements, including a doctor’s certification of terminal illness.	MEDICARE PAYS All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care	PLAN A PAYS Medicare copayment/coinsurance	YOU PAY $0

* A benefit period begins on the first day you receive service as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the plan stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy's "Core Benefits." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.

MEDICAL EXPENSES

IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as Physician’s services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
First $240 of Medicare Approved Amounts*	MEDICARE PAYS $0	PLAN A PAYS $0	YOU PAY $240
Remainder of Medicare Approved Amounts	Generally 80%	Generally 20%	$0

PART B EXCESS CHARGES

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
(ABOVE MEDICARE APPROVED AMOUNTS)	$0	$0	All costs

BLOOD

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
First 3 pints	$0	All costs	$0
Next $240 of Medicare-approved amounts*	$0	$0	$240 (Part B deductible)
Remainder of Medicare-approved amounts	80%	20%	$0

CLINICAL LABORATORY SERVICES

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
Tests For Diagnostic Services	100%	$0	$0

* Once you have been billed $240 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

HOME HEALTHCARE

Medicare-approved Services

	ORIGINAL MEDICARE PAYS	PLAN A PAYS	YOU PAY
Medically necessary skilled care services and medical supplies	100%	$0	$0
Durable Medical Equipment	$0	$0	$240 info Part B deductible
Remainder of Medicare Approved Amounts	80%	20%	$0

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For more information, call
1-888-964-0854

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Medicare Supplements are insured by Members Health Insurance Company, Columbia, TN. Not connected with or endorsed by the U.S. or state government. This is a solicitation of insurance. A representative of Members Health Insurance Company may contact you. You must be a member of Indiana Farm Bureau, Inc. to enroll in Indiana Farm Bureau Medicare Supplement Plans.

MH-ING-CERTA-FL20-131; MH-ING-CERTD-FL20-093; MH-ING-CERTG-FL20-095; MH-ING-CERTN-FL20-097

Medicare Supplement Plan A

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Plan A Details

Plan A covers these basic benefits:

Hospitalization

Medical Expenses

Blood

Hospice

HOSPITALIZATION*

All but $1,632

$0

$1,632

All but $408 a day

$408 a day

$0

All but $816 a day

$816 a day

$0

$0

100% of Medicare eligible expenses

$0**

$0

$0

All costs

SKILLED NURSING FACILITY CARE

All approved amounts

$0

$0

All but $204 a day

$0

Up to $204 a day

$0

$0

All costs

BLOOD

$0

All costs

$0

100%

$0

$0

HOSPICE CARE

All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care

Medicare copayment/coinsurance

$0

MEDICAL EXPENSES

$0

$0

$240

Generally 80%

Generally 20%

$0

PART B EXCESS CHARGES

ORIGINAL MEDICARE PAYS

PLAN A PAYS

YOU PAY

$0

$0

All costs

BLOOD

ORIGINAL MEDICARE PAYS

PLAN A PAYS

YOU PAY

$0

All costs

$0

Next $240 of Medicare-approved amounts*

Remainder of Medicare-approved amounts

CLINICAL LABORATORY SERVICES

ORIGINAL MEDICARE PAYS

PLAN A PAYS

YOU PAY

100%

$0

$0

HOME HEALTHCARE

Medicare-approved Services

100%

For more information, call
1-888-964-0854