Minnesota

Medicare Supplement
Product Forms: MS-BSCMN 06 and MS-EXTMN 06

Benefits and Features
Coverage Ext. Basic Plan Basic Plan Optional Basic Plan Riders
A B C D E
Part A deductible          
Part A hospital co-payment (61-90 days)          
Part A hospital co-payment (91-150 days)          
Hospitalization beyond 150 days          
Part A blood deductible (3 pints)          
Skilled nursing facility co-payment (21-100 days)          
Part B deductible          
Part B 20% of eligible expenses          
Part B excess charges          
Preventative medical care            
Foreign travel          
Diabetes management and treatment (80%)            
At-home recovery          
State mandated benefits          
Exceptions and Limitations

We will NOT pay benefits for any expenses incurred for which a charge normally is not made when there is no insurance or any expense incurred before the policy date. We will not duplicate any benefit paid by Medicare.

Pre-existing Conditions

Our policies do NOT include a pre-existing conditions limitation.
Renewability Provision - Guaranteed Renewable - Premiums Subject to Change

We guarantee to renew your policy each time you send us the premium. It must be paid on or before the date it is due or during the 31 days that follow. Your policy stays in force during this time. We can change your premium only if we do the same to all policies of this form issued to persons of your class in your state.


MSUP3 MN 11-05