2023 Michigan Compiled Laws
Chapter 500 - Insurance Code of 1956
Act 218 of 1956 - The Insurance Code of 1956 (500.100 - 500.8302)
218-1956-38 - Chapter 38 Medicare Supplement Policies and Certificates (500.3801...500.3861)
Section 500.3815 - Outline of Coverage; Acknowledgment of Receipt; Compliance With Notice Requirements; Substitute; Language, Written or Electronic Format, and Required Items.
Sec. 3815.
(1) An insurer that offers a Medicare supplement policy shall provide to the applicant at the time of application an outline of coverage in written or electronic format and, except for direct response solicitation policies, shall obtain an acknowledgment of receipt of the outline of coverage from the applicant in written or electronic format. The outline of coverage provided to applicants under this section must consist of the following 4 parts:
(a) A cover page.
(b) Premium information.
(c) Disclosure pages.
(d) Charts displaying the features of each benefit plan offered by the insurer.
(2) Insurers shall comply with any notice requirements of the Medicare prescription drug, improvement, and modernization act of 2003, Public Law 108-173.
(3) If an outline of coverage is provided at the time of application and the Medicare supplement policy or certificate is issued on a basis that would require revision of the outline, a substitute outline of coverage properly describing the policy or certificate must accompany the policy or certificate when it is delivered and must contain the following statement, in not less than 12-point type, immediately above the company name:
NOTICE: Read this outline of coverage carefully.
It is not identical to the outline of coverage
provided on application and the coverage
originally applied for has not been issued.
(4) An outline of coverage under subsection (1) must be in the language and in a written or electronic format prescribed in this section and in not less than 12-point type. The letter designation of the plan must be shown on the cover page and the plans offered by the insurer must be prominently identified. Premium information must be shown on the cover page or immediately following the cover page and must be prominently displayed. The premium and method of payment mode must be stated for all plans that are offered to the applicant. All possible premiums for the applicant must be illustrated. The following items must be included in the outline of coverage in the order prescribed below and in substantially the following form, as approved by the director:
BENEFIT CHART OF MEDICARE SUPPLEMENT PLANS SOLD
ON OR AFTER JUNE 1, 2010
This chart shows the benefits included in each of the standard Medicare supplement plans. Every company must make Plan "A" available. Some plans may not be available in your state.
Plans E, H, I, and J are no longer available for sale. (This sentence must not appear after June 1, 2011.)
BASIC BENEFITS:
Hospitalization: Part A coinsurance plus coverage for 365
additional days after Medicare benefits end.
Medical Expenses: Part B coinsurance (generally 20% of
Medicare-approved expenses) or copayments for hospital
outpatient services. Plans K, L, and N require insureds
to pay a portion of Part B coinsurance or copayments.
Blood: First three pints of blood each year.
Hospice: Part A coinsurance
A
B
C**
D
F|F* **
G/G*
Basic,
Basic,
Basic,
Basic,
Basic,
Basic,
including
including
including
including
including
including
100% Part
100% Part
100% Part
100% Part
100% Part
100% Part
B coin-
B coinsur-
B coinsur-
B coinsur-
B coinsur-
B coinsur-
surance
ance
ance
ance
ance
ance
Skilled
Skilled
Skilled
Skilled
Nursing
Nursing
Nursing
Nursing
Facility
Facility
Facility
Facility
Coinsur-
Coinsur-
Coinsur-
Coinsur-
ance
ance
ance
ance
Part A
Part A
Part A
Part A
Part A
Deductible
Deductible
Deductible
Deductible
Deductible
Part B
Part B
Deductible
Deductible
Part B
Part B
Excess
Excess
(100%)
(100%)
Foreign
Foreign
Foreign
Foreign
Travel
Travel
Travel
Travel
Emergency
Emergency
Emergency
Emergency
K
L
M
N
Hospitalization
Hospitalization
Basic,
Basic, includ-
and preventive
and preventive
including 100%
ing 100% Part B
care paid at
care paid at
Part B
coinsurance,
100%; other
100%; other
coinsurance
except up to
basic benefits
basic benefits
$20 copayment
paid at 50%
paid at 75%
for office
visit, and up
to $50 copay-
ment for ER
50% Skilled
75% Skilled
Skilled
Skilled
Nursing
Nursing
Nursing
Nursing
Facility
Facility
Facility
Facility
Coinsurance
Coinsurance
Coinsurance
Coinsurance
50% Part A
75% Part A
50% Part A
Part A
Deductible
Deductible
Deductible
Deductible
Foreign
Foreign
Travel
Travel
Emergency
Emergency
Out-of-pocket
Out-of-pocket
limit $5,240;
limit $2,620;
paid at 100%
paid at 100%
after limit
after limit
reached
reached
* Plans F and G also have options called high-deductible Plan F and high-deductible Plan G. These high-deductible plans pay the same benefits as Plan F or Plan G, as applicable, after one has paid a calendar year $2,240 deductible. Benefits from high-deductible Plan F or high-deductible Plan G will not begin until out-of-pocket expenses exceed $2,240. Out-of-pocket expenses for these deductibles are expenses that would ordinarily be paid by the policy. These expenses include the Medicare deductibles for Part A and Part B, but do not include the plan's separate foreign travel emergency deductible.
** Plan C, Plan F, and high-deductible Plan F are only available to individuals eligible for Medicare before January 1, 2020.
PREMIUM INFORMATION
We (insert insurer's name) can only raise your premium if we raise the premium for all policies like yours in this state. (If the premium is based on the increasing age of the insured, include information specifying when premiums will change).
DISCLOSURES
Use this outline to compare benefits and premiums among policies, certificates, and contracts.
This outline shows benefits and premiums of policies sold for effective dates on or after June 1, 2010. Policies sold for effective dates before June 1, 2010 have different benefits and premiums. Plans E, H, I, and J are no longer available for sale. (This sentence must not appear after June 1, 2011.)
READ YOUR POLICY VERY CAREFULLY
This is only an outline describing your policy's most important features. The policy is your insurance contract. You must read the policy itself to understand all of the rights and duties of both you and your insurance company.
RIGHT TO RETURN POLICY
If you find that you are not satisfied with your policy, you may return it to (insert insurer's address). If you send the policy back to us within 30 days after you receive it, we will treat the policy as if it had never been issued and return all of your payments.
POLICY REPLACEMENT
If you are replacing another health insurance policy, do not cancel it until you have actually received your new policy and are sure you want to keep it.
NOTICE
This policy may not fully cover all of your medical costs.
[For agent issued policies]
Neither (insert insurer's name) nor its agents are connected with Medicare.
[For direct response issued policies]
(Insert insurer's name) is not connected with Medicare.
This outline of coverage does not give all the details of Medicare coverage. Contact your local social security office or consult "The Medicare Handbook" for more details.
COMPLETE ANSWERS ARE VERY IMPORTANT
When you fill out the application for the new policy, be sure to answer truthfully and completely all questions about your medical and health history. The company may cancel your policy and refuse to pay any claims if you leave out or falsify important medical information. [If the policy or certificate is guaranteed issue, this paragraph need not appear.]
Review the application carefully before you sign it. Be certain that all information has been properly recorded.
[Include for each plan offered by the insurer a chart showing the services, Medicare payments, plan payments, and insured payments using the same language, in the same order, and using uniform layout and format as shown in the charts that follow. An insurer may use additional benefit plan designations on these charts under section 3809(1)(k). Include an explanation of any innovative benefits on the cover page and in the chart, in a manner approved by the director. The insurer issuing the policy shall change the dollar amounts each year to reflect current figures. No more than 4 plans may be shown on 1 chart.] Charts for each plan are as follows:
PLAN A
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$0
$1,340
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after:
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
$0
Up to
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
You must meet
All but very
$0
Medicare's requirements
limited
Medicare
including a doctor's
copayment/
copayment/
certification of terminal
coinsurance
coinsurance
illness
for outpatient
drugs and
inpatient
respite care
**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.
PLAN A
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All Costs
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of
Medicare
$0
$0
$183
Approved Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare
$0
$0
$183
Approved Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
PLAN B
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,340
$0
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
$0
Up to
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
All but very
limited
Medicare
$0
copayment/
copayment/
coinsurance
coinsurance
You must meet
for outpatient
Medicare's requirements,
drugs and
including a doctor's
inpatient
certification of
respite care
terminal illness
**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.
PLAN B
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All Costs
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Remainder of Medicare
Deductible)
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
PLAN C
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,340
$0
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
$0
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
All but very
$0
limited
Medicare
copayment/
copayment/
coinsurance
coinsurance
You must meet
for outpatient
Medicare's requirements,
drugs and
including a doctor's
inpatient
certification of
respite care
terminal illness
**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.
PLAN C
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$183
$0
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All Costs
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of Medicare
Approved Amounts*
$0
$183
$0
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$183
$0
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—
Not covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit
$50,000
of $50,000
lifetime
maximum
PLAN D
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,340
$0
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
$0
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
All but very
Medicare
$0
limited
copayment/
copayment/
coinsurance
coinsurance
You must meet
for outpatient
Medicare's requirements,
drugs and
including a doctor's
inpatient
certification of
respite care
terminal illness
**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.
PLAN D
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All Costs
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—
Not covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit
$50,000
of $50,000
lifetime
maximum
PLAN F OR HIGH-DEDUCTIBLE PLAN F
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
**This high-deductible plan pays the same benefits as plan F after you have paid a calendar year $2,240 deductible. Benefits from the high-deductible plan F will not begin until out-of-pocket expenses are $2,240. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes Medicare deductibles for part A and part B, but does not include the plan's separate foreign travel emergency deductible.
SERVICES
MEDICARE
AFTER YOU
IN ADDITION
PAYS
PAY
TO
$2,240
$2,240
DEDUCTIBLE**,
DEDUCTIBLE**,
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,340
$0
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0***
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
$0
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
All but very
Medicare
$0
limited
copayment/
copayment/
coinsurance
coinsurance
You must
for
meet Medicare's
outpatient
requirements, including
drugs and
a doctor's certification
inpatient
of terminal illness
respite care
***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.
PLAN F
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
**This high-deductible plan pays the same benefits as plan F after you have paid a calendar year $2,240 deductible. Benefits from the high-deductible plan F will not begin until out-of-pocket expenses are $2,240. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes Medicare deductibles for part A and part B, but does not include the plan's separate foreign travel emergency deductible.
SERVICES
MEDICARE
AFTER YOU
IN ADDITION
PAYS
PAY
TO
$2,240
$2,240
DEDUCTIBLE**,
DEDUCTIBLE**,
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$183
$0
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
100%
$0
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of
Medicare Approved
$0
$183
$0
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$183
$0
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—
Not covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit
$50,000
of $50,000
lifetime
maximum
PLAN G OR HIGH-DEDUCTIBLE PLAN G
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
** This high-deductible plan pays the same benefits as Plan G after one has paid a calendar year $2,240 deductible. Benefits from the high-deductible Plan G will not begin until out-of-pocket expenses are $2,240. Out-of-pocket expenses for this deductible include expenses for the Medicare Part B deductible, and expenses that would ordinarily be paid by the policy. This does not include the plan's separate foreign travel emergency deductible.
SERVICES
MEDICARE PAYS
AFTER YOU
IN ADDITION
PAY
TO
$2,240
$2,240
DEDUCTIBLE**,
DEDUCTIBLE**,
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,340
$0
$1,340
(Part A
Deductible)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0***
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
$0
$167.50 a day
$167.50 a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
All but very
$0
limited
Medicare
copayment/
copayment/
coinsurance
coinsurance
You must meet
for outpatient
Medicare's requirements,
drugs and
including a doctor's
inpatient
certification of
respite care
terminal illness
***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.
PLAN G OR HIGH-DEDUCTIBLE PLAN G
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
** This high-deductible plan pays the same benefits as Plan G after one has paid a calendar year $2,240 deductible. Benefits from the high-deductible Plan G will not begin until out-of-pocket expenses are $2,240. Out-of-pocket expenses for this deductible include expenses for the Medicare part B deductible, and expenses that would ordinarily be paid by the policy. This does not include the plan's separate foreign travel emergency deductible.
SERVICES
MEDICARE PAYS
AFTER YOU
IN ADDITION
PAY
TO
$2,240
$2,240
DEDUCTIBLE**,
DEDUCTIBLE**,
PLAN PAYS
YOU PAY
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,
First $183 of
Medicare Approved
$0
$0
$163
Amounts*
(Unless
Part B
Deductible
has been
met)
Remainder of Medicare
Approved Amounts
80%
20%
$0
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
100%
0%
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Unless
Part B
Deductible
has been
met)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—
Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$0
$183
Amounts*
(Part B
Deductible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—
Not covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit
$50,000
of $50,000
lifetime
maximum
PLAN K
*You will pay half the cost-sharing of some covered services until you reach the annual out-of-pocket limit of $5,240 each calendar year. The amounts that count toward your annual limit are noted with diamonds 1 in the chart below. Once you reach the annual limit, the plan pays 100% of your Medicare copayment and coinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called "Excess Charges") and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.
PLAN K
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
**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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY*
HOSPITALIZATION**
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$670
$670
$1,340
(50%
(50% of
of Part A
Part A
Deducti-
Deductible) 1
ble)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after:
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0***
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
Up to
$167.50 a
$83.75
$83.75
day
a day
a day 1
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
50%
50% 1
Additional amounts
100%
$0
$0
HOSPICE CARE
50% of
50% of
copayment/
Medicare
coinsur-
copayment/
ance
coinsurance 1
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
***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.
PLAN K
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
****Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY*
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,
First $183 of
Medicare Approved
$0
$0
$183
Amounts****
(Part B
Deductible)
**** 1
Preventive Benefits for
Generally 75%
Remainder
All costs
Medicare covered
or more of
of Medi-
above Medi-
services
Medicare ap-
care
care
proved amounts
approved
approved
amounts
amounts
Remainder of Medicare
Generally 80%
Generally
Generally
Approved Amounts
10%
10% 1
Part B Excess Charges
$0
$0
All costs
(Above Medicare
(and they do
Approved Amounts)
not count
toward
annual out-
of-pocket
limit of
$5,240)*
BLOOD
First 3 pints
$0
50%
50% 1
Next $183 of
Medicare Approved
$0
$0
$183
Amounts****
(Part B
Deductible)
**** 1
Remainder of Medicare
Generally 80%
Generally
Generally
Approved Amounts
10%
10% 1
CLINICAL LABORATORY
SERVICES—Tests for
diagnostic services
100%
$0
$0
*This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $5,240 per year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called "Excess Charges") and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$0
$183
Amounts*****
(Part B
Deductible)1
Remainder of Medicare
Approved Amounts
80%
10%
10% 1
*****Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.
PLAN L
*You will pay one-fourth of the cost-sharing of some covered services until you reach the annual out-of-pocket limit of $2,620 each calendar year. The amounts that count toward your annual limit are noted with diamonds 1 in the chart below. Once you reach the annual limit, the plan pays 100% of your Medicare copayment and coinsurance for the rest of the calendar year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called "Excess Charges") and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.
PLAN L
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
**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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY*
HOSPITALIZATION**
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but
$1,005
$335
$1,340
(75% of
(25% of
Part A
Part A
Deducti-
Deductible) 1
ble)
61st thru 90th day
All but
$335
$0
$335 a day
a day
91st day and after:
—While using 60
lifetime reserve days
All but
$670
$0
$670 a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0***
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
amounts
$0
$0
21st thru 100th day
All but
Up to
Up to
$167.50 a
$125.63
$41.88
day
a day
a day 1
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
75%
25% 1
Additional amounts
100%
$0
$0
HOSPICE CARE
75% of
25% of
copayment/
copayment/
coinsur-
coinsurance 1
ance
You must meet
Medicare's requirements,
including a doctor's
certification of terminal
All
illness
but very
limited copay-
ment/coinsur-
ance for
outpatient
drugs and
inpatient
respite care
***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.
PLAN L
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
****Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY*
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,
First $183 of
Medicare Approved
$0
$0
$183
Amounts****
(Part
B Deducti-
ble)**** 1
Preventive Benefits for
Generally 75%
Remainder
All costs
Medicare covered
or more of
of Medi-
above Medi-
services
Medicare
care
care
approved
approved
approved
amounts
amounts
amounts
Remainder of Medicare
Generally
Generally
Generally
Approved Amounts
80%
15%
5% 1
Part B Excess Charges
$0
$0
All costs
(Above Medicare
(and they do
Approved Amounts)
not count
toward
annual out-
of-pocket
limit of
$2,620)*
BLOOD
First 3 pints
$0
75%
25% 1
Next $183 of
Medicare Approved
$0
$0
$183
Amounts****
(Part B
Deductible) 1
Remainder of Medicare
Generally
Generally
Generally
Approved Amounts
80%
15%
5% 1
CLINICAL LABORATORY
SERVICES—Tests for
diagnostic services
100%
$0
$0
*This plan limits your annual out-of-pocket payments for Medicare-approved amounts to $2,620 per year. However, this limit does NOT include charges from your provider that exceed Medicare-approved amounts (these are called "Excess Charges") and you will be responsible for paying this difference in the amount charged by your provider and the amount paid by Medicare for the item or service.
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
$0
$0
$183
Amounts*****
(Part
B Deducti-
ble) 1
Remainder of Medicare
Approved Amounts
80%
15%
5% 1
*****Medicare benefits are subject to change. Please consult the latest Guide to Health Insurance for People with Medicare.
PLAN M
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but $1,340
$670 (50%
$670 (50%
of Part A
of Part A
Deduc-
Deduc-
tible)
tible)
61st thru 90th day
All but $335
$335
$0
a day
a day
91st day and after:
—While using 60
lifetime reserve days
All but $670
$670
$0
a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
$0
$0
amounts
21st thru 100th day
All but $167.50
Up to $167.50
$0
a day
a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
You must meet Medicare's
All but very
Medicare
$0
requirements, including
limited
copayment/
a doctor's
copayment/
coinsurance
certification of
coinsurance
terminal illness
for outpatient
drugs and
inpatient
respite care
**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.
PLAN M
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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
First $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
Generally
Generally
$0
80%
20%
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All Costs
BLOOD
First 3 pints
$0
All costs
$0
Next $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
Amounts
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—Not
covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of Charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit of
$50,000
$50,000
lifetime
maximum
PLAN N
MEDICARE (PART A)—HOSPITAL SERVICES—PER BENEFIT PERIOD
*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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY*
HOSPITALIZATION*
Semiprivate room and
board, general nursing
and miscellaneous
services and supplies
First 60 days
All but $1,340
$1,340
$0
(Part A
Deduc-
tible)
61st thru 90th day
All but $335
$335
$0
a day
a day
91st day and after:
—While using 60
lifetime reserve days
All but $670
$670
$0
a day
a day
—Once lifetime reserve
days are used:
—Additional 365 days
$0
100% of
$0**
Medicare
Eligible
Expenses
—Beyond the
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 the
hospital
First 20 days
All approved
$0
$0
amounts
21st thru 100th day
All but $167.50
Up to $167.50
$0
a day
a day
101st day and after
$0
$0
All costs
BLOOD
First 3 pints
$0
3 pints
$0
Additional amounts
100%
$0
$0
HOSPICE CARE
You must meet Medicare's
All but very
Medicare
$0
requirements, including
limited
copayment/
a doctor's certification
copayment/
coinsurance
of terminal illness
coinsurance
for outpatient
drugs and
inpatient
respite care
**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.
PLAN N
MEDICARE (PART B)—MEDICAL SERVICES—PER CALENDAR YEAR
*Once you have been billed $183 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.
SERVICES
MEDICARE PAYS
PLAN PAYS
YOU PAY
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
First $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
Generally
Balance,
Up to $20
80%
other than
per office
up to $20
visit and
per office
up to $50
visit and
per
up to $50
emergency
per
room
emergency
visit. The
room visit.
copayment
The
of up to
copayment
$50 is
of up to
waived if
$50 is
the
waived if
insured is
the insured
admitted
is admitted
to any
to any
hospital
hospital
and the
and the
emergency
emergency
visit is
visit is
covered as
covered as
a Medicare
a Medicare
Part A
Part A
expense.
expense.
Part B Excess Charges
(Above Medicare
Approved Amounts)
$0
$0
All costs
BLOOD
First 3 pints
$0
All Costs
$0
Next $183 of Medicare
Approved Amounts*
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
CLINICAL LABORATORY
SERVICES—Tests for
diagnostic services
100%
$0
$0
PARTS A & B
HOME HEALTH CARE
Medicare Approved
Services
—Medically necessary
skilled care services
and medical supplies
100%
$0
$0
—Durable medical
equipment
First $183 of
Medicare Approved
Amounts*
$0
$0
$183
(Part B
Deduc-
tible)
Remainder of Medicare
Approved Amounts
80%
20%
$0
OTHER BENEFITS—NOT COVERED BY MEDICARE
FOREIGN TRAVEL—Not
covered by Medicare
Medically necessary
emergency care services
beginning during the
first 60 days of each
trip outside the USA
First $250 each
calendar year
$0
$0
$250
Remainder of Charges
$0
80% to a
20% and
lifetime
amounts
maximum
over the
benefit of
$50,000
$50,000
lifetime
maximum
History: Add. 1992, Act 84, Imd. Eff. June 2, 1992 ;-- Am. 2002, Act 304, Imd. Eff. May 10, 2002 ;-- Am. 2006, Act 462, Imd. Eff. Dec. 20, 2006 ;-- Am. 2009, Act 220, Imd. Eff. Jan. 5, 2010 ;-- Am. 2018, Act 429, Eff. Mar. 20, 2019
Compiler's Notes: In Plans K and L, a superscript numeral "1" has been substituted wherever a diamond symbol should occur.
Popular Name: Act 218
