$50 copay combined visits In and Out of Network Home Health Care $0 copay 50% of the costĭiabetes Monitoring Supplies 2 $0 copay for covered brands 50% of the costĮye Exam 3 $0 copay 1 per year $50 copay combined visits In and Out of Network $0 copay per day: Days 52-100 $225 copay per day: Days 1-40 Skilled Nursing Facility $0 copay per day: Days 1-20 Outpatient Hospital Services (includes observation services) 2 $0 copay - $250 copay $495 copayĪmbulatory Surgical Center 2 $0 copay - $200 copay $495 copayĭiagnostic Tests and Procedures, non-radiological (such as EKG/ECG tests, etc.)ĭiagnostic Tests and Procedures, non-radiological (such as EKG/ECG tests, etc.) $20 copay $40 copayĭiagnostic Radiology Services (such as MRIs/CT scans, etc.)ĭiagnostic Radiology Services (such as MRIs/CT scans, etc.) $0 copay - $110 copay $200 copay Outpatient Hospital Services (includes observation services) $0 copay per day for unlimited days after that $0 copay per day for unlimited days after that $495 copay per day: Days 1-10 Inpatient Hospital Care $295 copay per day: Days 1-5 $90 copay per visit ($0 copay when outside of the United States)Īmbulance Services $225 copay for ground or air $225 copay for ground or air $40 copay per visit ($0 copay when outside of the United States)Įmergency Care $90 copay per visit ($0 copay when outside of the United States) $90 copay per visit ($0 copay when outside of the United States) Urgent Care $40 copay per visit ($0 copay when outside of the United States) $40 copay per visit ($0 copay when outside of the United States) $0 copay for at least 3-month supply of Tier 1 medications with Preferred Mail Home Delivery from OptumRx. Preferred Mail Home Delivery through OptumRx The money you spend using your card counts toward your out-of-pocket costs.Īfter your total out-of-pocket costs reach $7,400, you will pay the greater of $4.15 copay for generic (including brand drugs treated as generic), and $10.35 copay for all other drugs, or 5% coinsurance. Always use your Medicare Advantage member ID card during the coverage gap to get the plan's discounted drug rates. You may pay less if your plan has additional coverage in the gap. If your plan has an annual deductible, you (or others on your behalf) will pay your drug costs up to the amount of this deductible before moving into the Initial Coverage stage.ĭuring the Coverage Gap Stage, you (or others on your behalf) will pay no more than 25% of the price for generic drugs or 25% of the price (plus the dispensing fee) for brand name drugs, for any drug tier until the total amount you (or others on your behalf) have paid reaches $7,400 in year-to-date out-of-pocket costs. Opioid Treatment Services $0 copay $0 copay Mental Health (outpatient) Group: $15 copay $0 copay - 40% of the cost (depending on the service) Preventive Services (such as covered screenings, vaccinations, etc.) 2 $0 copay for covered services $0 copay - 40% of the cost (depending on the service) Preventive Services (such as covered screenings, vaccinations, etc.) $0 copay Speak to network telehealth providers using your computer or mobile device.Īnnual Routine Physical 4 $0 copay 1 per year 40% of the cost combined visits In and Out of NetworkĤ0% of the cost combined visits In and Out of Network $0 copay Speak to network telehealth providers using your computer or mobile device. To find which plan best fits your needs and budget, start with a plan comparison tool.Virtual Medical Visits $0 copay Speak to network telehealth providers using your computer or mobile device. Who should enroll in a Medicare Advantage plan?Īnyone who is eligible for Original Medicare can choose a Medicare Advantage plan. Coverage and costs can vary by plan and location. To join a plan, you need to live in its service area. Medicare Advantage plans operate within defined geographic regions called service areas. What Medicare Advantage plans are available to me? Most Medicare Advantage plans also include prescription drug benefits. Medicare prescription drug (Part D) plans are generally used in addition to Original Medicare. Medigap adds to Original Medicare while Medicare Advantage replaces it. Medicare supplement insurance, also called Medigap, is also available from private insurance companies. Is it different from Medicare Supplement insurance? Medicare Advantage plans are offered by private insurance companies. Original Medicare plans come directly from the federal government. It usually includes prescription drug coverage and may offer additional benefits such as dental, vision and fitness, often at no additional premium charge. A Medicare Advantage (Part C) plan combines Original Medicare Part A (hospital insurance) and Part B (medical insurance) in one plan.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |