Medicare Supplement Plans
Plan offerings vary by county. Please select your county:
Download Our Brochure and Outline of Coverage
Medicare Supplement BrochureOpen a PDF 01/01/2024
Medicare Supplement Outline of CoverageOpen a PDF 01/01/2024
Download Our Brochure and Outline of Coverage
Medicare Supplement BrochureOpen a PDF 01/01/2024
Medicare Supplement Outline of CoverageOpen a PDF 01/01/2024
Download Our Brochure and Outline of Coverage
Medicare Supplement BrochureOpen a PDF 01/01/2024
Medicare Supplement Outline of CoverageOpen a PDF 01/01/2024
The Monthly Premiums listed on this page are effective 1/1/2024. Please review the Outline of Coverage for more information.
Highlight of benefits for Medicare Supplement Plans D, G and G+
| Benefit Category | With Original Medicare alone in you pay | With Plan D you pay | With Plan G you pay | With Plan D you pay | With Plan G you pay | With Plan D you pay | With Plan G you pay | With Plan D you pay | With Plan G you pay | With Plan D you pay | With Plan G you pay | With Plan G+, After $2800 Deductible Is Met, you pay | With Plan G+, After $2,800 Deductible Is Met, you pay | With Plan G+ you pay | With Plan G+ you pay | With Plan G+ you pay |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Part A Deductible | $1,632 | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Part B Deductible | $240 | $240 | $240 | $240 | $240 | $240 | $240 | |||||||||
| Part B Excess Charge * | All Costs | All Costs | $0 | All Costs | $0 | $0 | $0 | |||||||||
| Inpatient Hospital Care (per benefit period) | Days 1 - 60: $1,632 deductible Days 61 - 90: $408 Per Day Days 91 and after: $816 Per Day |
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|||||||||
| Doctor Office Visits (primary care and specialists) | 20% after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | |||||||||
| Skilled Nursing Facility Care (per benefit period) | Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|||||||||
| Clinical Laboratory Service | 100% | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Emergency Care | 20% after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | |||||||||
| Foreign Travel Emergency Care | All Costs | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | |||||||||
| Durable Medical Equipment | $240 Part B Deductible toward the Medicare-approved amount. 20% of the remaining Medicare-approved amount. |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
|||||||||
| Monthly Premium | $402.75 | $404.71 | $402.75 | $404.71 | $402.75 | $404.71 | $402.75 | $404.71 | $71.15 | $71.15 | $71.15 | $71.15 | ||||
Get Started
Get help from a dedicated Medicare Sales Adviser by calling:
1-800-671-6081
TTY: 711
Monday - Friday, 8 a.m. - 8 p.m.
From Oct. 1 - March 31:
advisors are also available weekends 8 a.m. to 8 p.m.
Highlight of benefits for Medicare Supplement Plans N, A, and B
| Benefit Category | With Original Medicare alone in you pay | With Plan N you pay | With Plan A you pay | With Plan B you pay | With Plan N you pay | With Plan A you pay | With Plan B you pay | With Plan N you pay | With Plan A you pay | With Plan B you pay | With Plan N you pay | With Plan A you pay | With Plan B you pay | With Plan N you pay | With Plan A you pay | With Plan B you pay |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Part A Deductible | $1,632 | $0 | $1,632 | $0 | $0 | $1,632 | $0 | |||||||||
| Part B Deductible | $240 | $240 | $240 | $240 | $240 | $240 | $240 | |||||||||
| Part B Excess Charge * | All Costs | All Costs | All Costs | All Costs | All Costs | All Costs | All Costs | |||||||||
| Inpatient Hospital Care (per benefit period) | Days 1 - 60: $1,632 deductible Days 61 - 90: $408 Per Day Days 91 and after: $816 Per Day |
$0 |
$0, after you pay your Part A Deductible |
$0 |
$0 |
$0, after you pay your Part A Deductible |
$0 |
|||||||||
| Doctor Office Visits (primary care and specialists) | 20% after you pay your Part B Deductible | No more than $20 for each covered health care provider office visit, including visits to medical specialists | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | No more than $20 for each covered health care provider office visit, including visits to medical specialists | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | |||||||||
| Skilled Nursing Facility Care (per benefit period) | Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
$0 |
Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
$0 |
Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
|||||||||
| Clinical Laboratory Service | 100% | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Emergency Care | 20% after you pay your Part B Deductible | No more than $50 for each covered emergency room visit after Part B Deductible is met | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | No more than $50 for each covered emergency room visit after Part B Deductible is met | $0, after you pay your Part B Deductible | $0, after you pay your Part B Deductible | |||||||||
| Foreign Travel Emergency Care | All Costs | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | All Costs | All Costs | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | All Costs | All Costs | |||||||||
| Durable Medical Equipment | $240 Part B Deductible toward the Medicare-approved amount. 20% of the remaining Medicare-approved amount. |
$0 |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
$0, after you pay your Part B Deductible |
|||||||||
| Monthly Premium | $471.24 | $257.83 | $366.37 | $431.27 | $235.96 | $335.30 | $389.62 | $213.15 | $302.90 | $399.51 | $218.56 | $310.57 | ||||
Plan C, F and F+ will no longer be available for enrollment to those first eligible for Medicare on or after January 1, 2020.
| Benefit Category | With Original Medicare alone in you pay | With Plan C you pay | With Plan F you pay | With Plan F+, After $2,800 Deductible Is Met, you pay | With Plan C you pay | With Plan F you pay | With Plan F+, After $2,800 Deductible Is Met, you pay | With Plan C you pay | With Plan F you pay | With Plan F+ you pay | With Plan C you pay | With Plan F you pay | With Plan F+ you pay | With Plan C you pay | With Plan F you pay | With Plan F+ you pay |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Part A Deductible | $1,632 | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Part B Deductible | $240 | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Part B Excess Charge * | All Costs | All Costs | $0 | $0 | All Costs | $0 | $0 | |||||||||
| Inpatient Hospital Care (per benefit period) | Days 1 - 60: $1,632 deductible Days 61 - 90: $408 Per Day Days 91 and after: $816 Per Day |
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|||||||||
| Doctor Office Visits (primary care and specialists) | 20% after you pay your Part B Deductible | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Skilled Nursing Facility Care (per benefit period) | Days 1 - 20: $0 per day Days 21 - 100: $204 per day |
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|||||||||
| Clinical Laboratory Service | 100% | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Emergency Care | 20% after you pay your Part B Deductible | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
| Foreign Travel Emergency Care | All Costs | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | $250 Deductible, 20% of remaining costs, and any amount over $50,000 lifetime maximum | |||||||||
| Durable Medical Equipment | $240 Part B Deductible toward the Medicare-approved amount. 20% of the remaining Medicare-approved amount. |
$0 |
$0 |
$0 |
$0 |
$0 |
$0 |
|||||||||
| Monthly Premium | $410.28 | $484.20 | $78.43 | $375.51 | $443.18 | $78.43 | $339.21 | $400.31 | $78.43 | $347.80 | $410.47 | $78.43 | ||||
*Some healthcare providers charge more than the approved Medicare payment for services. The excess charge is the difference between the healthcare providers actual charge and Medicare's approved amount for payment
To learn about which plans are right for you, get help from a dedicated
Medicare Sales Advisor by calling: 1-800-671-60811-844-596-0345 (TTY 711).
The Medicare Supplement plans described are underwritten by Excellus Health Plan, Inc., which does business as Excellus BlueCross BlueShield.
The purpose of this website material is the solicitation of insurance.
These policies (EXC-83, EXC-85, EXC-86, EXC-87, EXC-88, EXC-89, EXC-100, EXC-101, EXC-104) meet the minimum standards for MEDICARE SUPPLEMENT INSURANCE as defined by the New York State Department of Financial Services. The expected benefit ratio for the policies is 85.4%. This ratio is the portion of future premiums which the company expects to return as benefits, when averaged over all people with this policy.
IMPORTANT NOTICE - A CONSUMER'S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICARE MAY BE OBTAINED FROM YOUR LOCAL SOCIAL SECURITY OFFICE OR FROM THIS INSURER.
A CONSUMER'S GUIDE TO HEALTH INSURANCE FOR PEOPLE ELIGIBLE FOR MEDICAREOpen a PDF
Excellus BlueCross BlueShieldUnivera Healthcare is not connected with or endorsed by the State of New York, the federal government or the federal Medicare program.
Put stuff here to only use one set of plan pages and NOT create new pages every year
MS-WEB-EX-3 (Rev. 4)
