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Anthem of Colorado
Health Insurance |
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| Oleg Skurskiy Authorized
Independent Agent for Anthem |
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New Enrollment
Only Call
(818)654-4548
| Anthem
Blue Medicare Supplement plans - Colorado |
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( PFFS- a Medicare Advantage
Private Fee-for-Service organization.
) low cost plans
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| Order
the Application
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Anthem
Medicare Supplements
Cover |
Anthem
Medicare Supplement
Application 
Printable Application |
| In
2006 Medicare Will
NOT Pay |
A |
B |
F |
I |
J |
| Part
A - Hospital Services |
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| $952
initial hospital deductible
each benefit
period |
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| $238
a day for days 61-90
in a hospital |
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| $476
a day for days 91-150
(your Lifetime
Reserve days) |
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| 100%
of Medicare- allowable
expenses for additional
365 days after Medicare
hospital benefits
stop completely |
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| Calendar-year
blood deductible
(first three pints
of blood) if the deductible
is not met by the
replacement of blood |
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| $119
per day for days 21-100
in a Skilled
Nursing Facilility |
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| Part
B - Physician and
Medical Services |
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| $124
Part B deductible |
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| 20%
of Medicare-approved
amount, or for
hospital outpatient
services, applicable
copayments,
after $124 Part B
deductible is met |
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| 100%
of Medicare Part B
excess charges. Excess
charges are charges
you are responsible
for paying that are
above Medicare's approved
amount |
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| Additional
Benefits Not Covered
by Medicare |
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| At-home
recovery benefits
Covers up to $40 a
visit for home care
certified by a physican
as necessary, or for
personal care where
Medicare has approved
a home treatment plan
for recovery from
an injury or sickness.
You must receive treatment
within 8 weeks of
your last Medicare
visit, limited to
7 visits per week,
up to $1,600 annually. |
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| Benefits
for medically necessary
emergency care received
in a foreign country.
Covers 80% of charges,
after a $250 calendar-year
deductible, up to
a $50,000 lifetime
maximum. |
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* The Monthly Household Premium
amount is shown for your budgeting
purposes only. Each policy is considered
separate and will be billed accordingly.
This information
is not your policy and is intended
as a brief summary of service. If
there is any difference between
this page and the policy, the provisions
of the policy shall control. To
understand the terms of the medicare
supplemental policy you are considering,
please read Certificate Form # 's
95265, 95266, 95267, 95268, and
Application Form # 80109. To obtain
a copy of these forms, please call
our sales department |
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New
Enrollment Only Call
(818) 654 - 4548
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APPLICATION MAIL TO: |
Oleg
Skurskiy
18375 Ventura Blvd. # 226
Tarzana , CA 91356 |
You
also can fax complete application
to Fax: (818) 776-9865 |
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Anthem Insurance Companies, Inc (AICI) is the
legal entity under contract with the Centers for
Medicare and Medicaid Services (CMS) authorized
to offer the applicable Medicare Prescription
Drug (Part D) plans and services in this region.
AICI is the legal entity licensed under applicable
state law or under a federal waiver program that
is authorized to offer these Part D plans. AICI
has partnered with its affiliated local companies
to provide various administrative and management
services for these Part D plan(s).
Anthem Blue Cross and Blue Shield is the trade
name for the following: In Connecticut: Anthem
Health Plans, Inc. In Colorado, Rocky Mountain
Hospital and Medical Service, Inc. In Indiana:
Anthem Insurance Companies, Inc. In Kentucky:
Anthem Health Plans of Kentucky. In Maine: Anthem
Health Plans of Maine, Inc. In Nevada: Rocky Mountain
Hospital and Medical Service, Inc. In New Hampshire:
Anthem Health Plans of New Hampshire, Inc. In
Ohio: Community Insurance Company. In Virginia:
Anthem Health Plans of Virginia, Inc. Independent
licensees of the Blue Cross and Blue Shield Association.
Serving residents and businesses in Indiana, Kentucky,
Ohio, Colorado, Nevada, Connecticut, Maine, New
Hampshire and Virginia (excluding the city of
Fairfax, the town of Vienna and the area east
of State Route 123). |
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Copyright © 2005 Oleg Skurskiy Authorized
Independent Agent, CA License 0E50389 |
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