| Rates effective 6/1/2010 |
Plan A |
Plan F |
Plan K |
Plan L |
| Male/65yr - 97402 (EFT) |
$96.42 |
$132.27 |
$63.39 |
$94.10 |
| Male/65yr - 97021 (EFT) |
$101.01 |
$138.57 |
$71.64 |
$98.59 |
| Female/65yr - 97402 (EFT) |
$83.83 |
$115.00 |
$59.46 |
$81.82 |
| Female/65yr - 97021 (EFT) |
$87.82 |
$120.48 |
$62.29 |
$85.72 |
| Benefits |
Plan A |
Plan F |
Plan K |
Plan L |
| Medicare Part A Coinsurance and Hospital Benefits |
 |
|
|
|
| Medicare Part A Deductible |
|
|
50% |
75% |
| Medicare Part B Coinsurance or Co-payment |
|
|
50% |
75% |
| Medicare Part B Deductible |
|
|
|
|
| Medicare Part B Excess Charges |
|
|
|
|
| Blood (First Three Pints) |
|
|
50% |
75% |
| Hospice Care Coinsurance or Co-payment |
|
|
50% |
75% |
| Skilled Nursing Coinsurance |
|
|
50% |
75% |
| Foreign Travel Emergency (Up to Plan Limits)3 |
|
|
|
|
| Medicare Preventive Care Part B Coinsurance |
|
|
|
|
| 2010 out-of-pocket limit4 |
|
|
$4,620 |
$2,310 |
HealthNet
Oregon 
