Original Medicare Part A’s deductible
Part B deductible
Part B excess charges
Part A coinsurance and hospital costs up to an additional 365 days after Medicare’s benefits are all used up
Part B coinsurance or copayments
First three pints of blood used in an approved medical procedure
Skilled nursing facility coinsurance
80% of a foreign travel emergency (up to plan limits)

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Coverage options vary by eligibility and provider.