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Farm Bureau Health Plans
Medicare Supplement Plans

Plan G

Plan G offers comprehensive coverage, including Medicare Part B excess charges. This plan does not cover the Medicare Part B deductible.
Guaranteed Renewable:

As long as you make premium payments on time, do not file claims with false or misleading information, and maintain your annual membership dues, you'll have the security of our Medicare Supplement coverage as long as you want it.

Money Back Guarantee:

If you are not 100 percent satisfied with your Farm Bureau Health Plans Medicare Supplement, return the EOC 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 G covers these basic benefits:
Hospitalization

Part A coinsurance pays coverage for 365 additional days after Medicare benefits end
Medical Expenses

Part B coinsurance (generally 20% of Medicare-approved expenses)
Blood

First three pints of blood each year
Hospice

Part A coinsurance
HOSPITALIZATION*
Semiprivate room and board, general nursing and miscellaneous services and supplies
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First 60 Days
All but $1600
$1600 (Part A deductible)
$0
61st thru 90th day
All but $400 a day
$400 a day
$0
91st day and after: -While using 60 lifetime reserve days
All but $800 a day
$800 a day
$0
Once lifetime reserve days are used: -Additional 365 days
$0
100% of Medicare eligible expenses
$0**
-Beyond additional 365 days
$0
$0
All costs
SKILLED NURSING FACILITY CARE
You must meet Medicare’s requirements, including having been in a hospital for at least 3 days and entered a Medicare approved facility within 30 days after leaving hospital
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First 20 days
All approved amounts
$0
$0
21st thru 100th day
All but $200 a day
Up to $200 a day
$0
101st day and after
$0
$0
All costs
BLOOD
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
MEDICARE PAYS
PLAN G PAYS
YOU PAY
You must meet Medicare’s requirements, including a doctor’s certification of terminal illness
All but very limited copayment/coinsurance for outpatient drugs and inpatient respite care
Medicare copayment/coinsurance
$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 insurer 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
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First $226 of Medicare Approved Amounts*
$0
$0
$226

Part B deductible
Remainder of Medicare Approved Amounts
Generally 80%
Generally 20%
$0
PART B EXCESS CHARGES
MEDICARE PAYS
PLAN G PAYS
YOU PAY
(ABOVE MEDICARE APPROVED AMOUNTS)
$0
100%
$0
BLOOD
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First 3 pints
$0
All costs
$0
Next $233 of Medicare Approved Amounts*
$0
$0
$226

Part B deductible
Remainder of Medicare Approved Amounts
80%
20%
$0
CLINICAL LABORATORY SERVICES
MEDICARE PAYS
PLAN G PAYS
YOU PAY
Tests For Diagnostic Services
100%
$0
$0

* Once you  have been billed $226 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
MEDICARE PAYS
PLAN G PAYS
YOU PAY
Medically necessary skilled care services and medical supplies
100%
$0
$0
Durable Medical Equipment

First $233 of Medicare Approved Amounts
$0
$0
$226

Part B deductible
Remainder of Medicare Approved Amounts
80%
20%
$0
FOREIGN TRAVEL - NOT COVERED BY MEDICARE
Medically necessary emergency care services beginning during fist 60 days of each trip outside US
MEDICARE PAYS
PLAN G PAYS
YOU PAY
First $250 each calendar year
$0
$0
$250
Remainder of charges
$0
80% to a lifetime maximum benefit of $50,000
20% and amounts over $50,000 lifetime maximum

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