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Medicare Supplement Products, Mutual of Omaha  
Mutual of Omaha of Illinois

Your Out-of-Pocket Costs with Medicare

Part A: Inpatient Hospital

Feature Medicare Pays* You Pay*
Deductible Nothing $1,100
First 60 Days 100% $0
Coinsurance 61-90 days All but $275 a day $275 a day
Coinsurance 91-150 days All but $550 a day $550 a day
Coinsurance 151+ days Nothing Eligible Expenses
Blood All but three pints  
Skilled Nursing Facility Care
First 20 Days
100%  
Coinsurance 21-100 days All but $137.50 a day $137.50 a day

Part B: Supplemental Medical Coverage

Feature Medicare Pays* You Pay*
Deductible Nothing $155
Coinsurance
Generally 80% of Medicare approved expenses
Generally 20% of Medicare approved expenses
Excess Benefits Nothing  
Blood All but three pints  

Additional Benefits

Emergency Care Received Outside the U.S. Nothing  
At-home Recovery Visits Nothing  

*Reflects 2008 Medicare program

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