PrimeTime Choices Medicare Supplement Insurance offered by AultCare Insurance Company
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Medicare Supplement plans sold with effective dates for coverage on or after January 1, 2017
Plan Comparisons
This chart shows the benefits included in each of the standard Medicare Supplement plans.  Every company must make Plan “A” available.  Some plans may not be available in your state. 
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
  co-payments for hospital outpatient services.  Plans K, L, and N require insured to pay a portion of      
  part B coinsurance or co-payments.
· Blood—First three pints of blood each year.
· Hospice—Part A coinsurance.
Review Area 1 Rates
Review Area 2 Rates
Review Area 3 Rates
Plan A
Plan B**
Plan C**
Plan D**
Plan F/F*
Plan G
Plan K**
Plan L**
Plan M
Plan N
Basic, including 100%
​Part B    coinsurance
​Basic,​ including 100%
​Part B  
​coinsurance
Basic,​ including 100%
​Part B  
​coinsurance
Basic, including 100%
​Part B
​coinsurance
​Basic, including 100%
​Part B coinsurance
​Basic, including 100%
​Part B coinsurance
​Hospitalization
​& preventive
care paid at
100%; other
basic benefits
paid at 50%



​
Hospitalization
& preventive care paid at 100%; other basic benefits paid at 75%
​


​
Basic, including 100%
​Part B
​ coinsurance
 Part B  coinsurance, except up to $20      
​co-payment for office visit, &
​up to $50
​co-payment for ER 


​
 
 
Skilled Nursing     Facility
​coinsurance
Skilled Nursing     Facility
​coinsurance
Skilled Nursing    Facility coinsurance
Skilled Nursing    Facility coinsurance
50% Skilled
Nursing   
Facility
​coinsurance
75% Skilled Nursing    Facility coinsurance
Skilled Nursing    Facility
​coinsurance
Skilled Nursing    Facility
​ coinsurance
 
​Part A
​Deductible
​Part A
​Deductible
​Part A
​Deductible
​Part A
​Deductible
​Part A Deductible
50% Part A
​ Deductible
75% ​Part A Deductible
50% ​Part A Deductible
​Part A
​ Deductible
 
 
​Part B  
​Deductible
 
Part B    Deductible
 
 
 
 
 
 
 
 
 
​Part B Excess (100%)
Part B Excess (100%)
 
 
 
 
 
 
​Foreign ​Travel Emergency 
​Foreign ​Travel Emergency 
​Foreign Travel Emergency 
Foreign Travel Emergency 
 
 
​Foreign Travel Emergency 
Foreign ​Travel Emergency 
 
 
 
 
 
 
Out-of-Pocket
limit $5,120;
paid at 100%
after limit
​reached
​Out-of-Pocket limit $2,560; paid at 100% after limit reached
 
 
*Plan F also has an option called a high deductible plan F.  This high deductible plan pays the same benefits as Plan F after one has paid a calendar year $2,200 deductible.  Benefits from high deductible plan F will not begin until out-of-pocket expenses exceed $2,200.  Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy.  These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan’s separate foreign travel emergency deductible.

**PrimeTime Choices do not offer these plans. They are shown for transparency & comparison purposes only as they are all plans available in the Medicare Supplement market. 
Plans A, F, High Deductible F, G, M and N; are currently available through PrimeTime Choices Medicare Supplement Insurance, offered by AultCare Insurance Company.


Location

PrimeTime Choices
AultCare Insurance Company
Morrow House
2600 Sixth St SW
Canton, Ohio 44710
(330) 363-4031
(877) 863-1791

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