Common use of Basic Benefits Clause in Contracts

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medicare Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Med- icare Part B Deductible, after which pay- ment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. After the Subscriber has satisfied the Medi- care Part A Deductible. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; For any additional expenses incurred un- der Medicare Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Ex- penses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Med- icare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. , except for the following: (1) up to twenty dollars ($20) or the Medicare Part B copayment for each covered health care provider office visit including visits to medical spe- cialists; (2) up to fifty dollars ($50) or the Medi- care Part B copayment for each cov- ered emergency room visit. This copayment shall be waived if the Subscriber is admitted to any hospi- tal and the emergency visit is subse- quently covered as a Medicare Part A expense. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute sub-acute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay the Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible De- ductible provided the Subscriber is re- ceiving receiving concurrent benefits from Medicare Medi- care for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay the Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay the Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Servicesservices, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible de- ductible provided the Subscriber is re- ceiving receiving concurrent benefits from Medicare Medi- care for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) 60 lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Servicesservices, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible de- ductible provided the Subscriber is re- ceiving receiving concurrent benefits from Medicare Medi- care for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute sub-acute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount oramount, or in the case of hos- pital hospi- tal outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles required deductibles re- quired under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged encouraged to appropriately use the “911” emer- gency response emergency re- sponse system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute sub-acute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion ex- haustion of Medicare Benefits or reductions for coinsurance and Deductibles required under MedicareMed- icare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. After the Subscriber has satisfied the Medi- care Part A Deductible, Blue Shield will pay the following: a) a. Coverage of Part A Medicare Eligible Ex- penses Expenses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) b. Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) c. Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Med- icare Part A Eligible Expenses for hos- pitalization hospitali- zation will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program pro- gram is limited to 190 days during the Subscriber's Sub- ▇▇▇▇▇▇▇'▇ lifetime); d) d. Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute sub-acute skilled nursing facility or private room is certified as medically necessary by an attending PhysicianPhy- sician. 2. Blue Shield will pay the following: a) a. Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Med- icare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) b. Blue Shield will provide coverage for the coinsurance amount oramount, or in the case of hos- pital hospi- tal outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare Medi- care for the same Services. c) c. Blue Shield will provide coverage for hos- pice hospice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits Bene- fits or reductions for coinsurance and Deductibles De- ductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Servicesservices, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits or reductions for coinsurance and Deductibles Deducti- bles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Benefit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate appro- priate standard of payment which has been ap- proved approved by Medicare, subject to a lifetime life- time maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der under Part B regardless of hospital confine- mentcon- finement, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles deductibles required under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency emergen- cy response system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) 60 lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization hospitalization will be paid at the appropriate standard of payment which has been ap- proved approved by MedicareMed- icare, subject to a lifetime maximum benefit bene- fit of an additional 365 days (except that psychiatric care in a psychiat- ric psychiatric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute sub-acute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations. For any additional expenses incurred under Medi- care Part B, the Subscriber must pay a Medicare Part B Deductible, after which payment will be made at 20% of the billed charges for Medicare Eligible Expenses; b) Blue Shield will provide coverage for the coinsurance amount oramount, or in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles required deductibles re- quired under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged encouraged to appropriately use the “911” emer- gency response emergency re- sponse system where available.

Basic Benefits. 1. Blue Shield will pay the following: a) Coverage of Part A Medicare Eligible Ex- penses for hospitalization to the extent not covered by Medicare from the 61st day through the 90th day in any Medicare Ben- efit Period; b) Coverage of Part A Medicare Eligible Ex- penses incurred for hospitalization to the extent not covered by Medicare for each Medicare lifetime inpatient reserve day used. Each Medicare beneficiary is given sixty (60) lifetime reserve days which begin from the 91st day and after; c) Upon exhaustion of the Medicare hospital inpatient coverage including the sixty (60) lifetime reserve days, coverage for the Medicare Part A Eligible Expenses for hos- pitalization will be paid at the appropriate standard of payment which has been ap- proved by Medicare, subject to a lifetime maximum benefit of an additional 365 days (except that psychiatric care in a psychiat- ric hospital participating in the Medicare program is limited to 190 days during the Subscriber's lifetime); d) Room and board charges shall be no more than the charge for a semi-private accom- modation in the Hospital of confinement, unless confinement in a subacute skilled nursing facility or private room is certified as medically necessary by an attending Physician. 2. Blue Shield will also pay the following: a) Coverage for Medicare Parts A and B for the reasonable cost of the first three (3) pints of blood (or equivalent quantities of packed red blood cells, as defined under federal regulations) unless replaced in ac- cordance with federal regulations; b) Blue Shield will provide coverage for the coinsurance amount or, in the case of hos- pital outpatient Services, the copayment amount of Medicare Eligible Expenses un- der Part B regardless of hospital confine- ment, subject to the Medicare Part B Deductible provided the Subscriber is re- ceiving concurrent benefits from Medicare for the same Services. c) Blue Shield will provide coverage for hos- pice care which includes cost sharing for all Part A Medicare eligible hospice care and respite care expenses. 3. Benefits for the coverage listed above shall be paid when the Subscriber is not entitled to payment for such Services under Medicare by reason of exhaustion of Medicare Benefits benefits or reductions for coinsurance and Deductibles required deductibles re- quired under Medicare. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encour- aged to appropriately use the “911” emer- gency response system where available.