Plan A covers the four Basic Benefits, which include hospitalization, medical expenses, blood and hospice care. This plan does not cover the Part A inpatient deductible or Part B deductible. Once the deductibles are met, EmblemHealth pays Part A and Part B coinsurance (20 percent of Medicare-approved expenses), Medicare pays 80 percent.

In addition to the four Basic Benefits (which are hospitalization, medical expenses, blood and hospice care), Plan B also provides coverage for the Part A inpatient deductible of $1,676 in 2025. This is the amount you pay before Medicare begins to pay for hospitalizations.

Plan C builds on Plan B while also covering coinsurance (which is the percentage you pay for health services) for skilled nursing facility care, the Medicare Part B annual deductible of $257 in 2025, and emergency care used during foreign travel.

Only applicants eligible for Medicare prior to January 1, 2020 may purchase Plan C, Plan F and High Deductible Plan F

Plan F covers the same benefits of Plan C while adding 100% coverage of excess charges above what Medicare will pay on Part B.

Only applicants eligible for Medicare prior to January 1, 2020 may purchase Plan C, Plan F and
High Deductible Plan F

This is a high deductible plan that pays the same benefits as Plan F after one has paid a calendar year deductible of $2,870 in 2025. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses exceed $2,870 in 2025. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.

Only applicants eligible for Medicare prior to January 1, 2020 may purchase Plan C, Plan F and High Deductible Plan F

Plan G is the closest replacement for Plan F.  Plan G covers everything that Plan F covers except for your annual Part B deductible of $257 in 2025.

This is a high deductible plan that pays the same benefits as Plan G after one has paid a calendar year deductible of $2,870 in 2025. Benefits from the high deductible Plan G will not begin until out-of-pocket expenses are $2,870 in 2025. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductible for Part A, but does not include the plan’s separate foreign travel emergency deductible.

Plan N is similar to Plan C but without coverage of the Part B Deductible. It combines some cost-sharing, which most people are already accustomed to, with these lower premiums. After the Medicare Part B annual deductible is met ($257 in 2025), it covers 100% of the Medicare Part B coinsurance costs, with the exception of a $20 copay for office visits and up to a $50 copay for emergency room visits or any Medicare Part B excess charges.