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MedicareBlue SupplementSM

2012 Medicare Supplement Plans

Available for coverage beginning January 1, 2012

	Plan A	Plan D	Plan F	High Deductible Plan F	Plan N
Plan Summary	Basic benefits, guaranteed acceptance.	Broader benefits with a lower premium.	Greatest benefit package.	Lowest cost option.	Lower cost plan with small copays.
Features of all Wellmark MedicareBlue SupplementSM Plans	Blue365® Member Discounts Local customer service No waiting periods, even for pre-existing conditions No claims filing when you see providers in Iowa or South Dakota No medical exams Nationwide acceptance
Part A (Hospital) Deductible		X	X	X	X
Part A Coinsurance
Days 61-150	X	X	X	X	X
365 Additional Hospital Days	X	X	X	X	X
Skilled Nursing Facility Coinsurance
Days 21-100		X	X	X	X
Part B (Medical) Deductible			X	X
Part B 20% Coinsurance	X	X	X	X	X (Except up to $20 per office visit and up to $50 per ER visit)
Part B Excess Charges			X	X
Foreign Travel Emergency (after first $250 each calendar year)		X	X	X	X
Outline of Coverage	MedicareBlue Supplement Iowa Outline of Coverage  (614KB) South Dakota Outline of Coverage  (486KB)

X indicates coverage.

MedicareBlue Supplement^SM is a Medicare supplement insurance plan. Medicare supplement plans are specific to Wellmark Blue Cross and Blue Shield and can only be purchased by Iowa or South Dakota residents. Enrollment and coverage in a MedicareBlue Supplement Medicare supplement plan is with Wellmark Blue Cross and Blue Shield of Iowa or Wellmark Blue Cross and Blue Shield of South Dakota, independent licensees of the Blue Cross and Blue Shield Association. MedicareBlue Supplement is not connected with or endorsed by the U.S. government or the federal Medicare Program.