2012 HIRSP Medicare Supplement Plan
Premiums
Medical deductible
(you pay) 		$500 per year
Medical Coinsurance (you pay) No
Individual medical out-of-pocket maximum (your total expenditures for medical deductible and medical coinsurance, after which HIRSP will pay at 100% $500 per year
Family medical out-of-pocket maximum (all family members must be on the same plan) $1,000 per year
Drug Copay (you pay) $5 Tier 1/ $55 Tier 2/ $75 Tier 3
Up to a maximum of $1,750 per year
Maximum lifetime benefit $2,000,000
Premium, Medical and Drug out-of-pocket reductions available if you qualify Yes, only premium & drug out-of-pocket