Saturday, May 25, 2024

 Certainly! Medicare Advantage (also known as Medicare Part C) is a popular form of health insurance coverage for U.S. adults aged 65 and older. However, with a staggering 8,676 different Medicare Advantage plans available for 2024 nationwide, finding the right plan can be overwhelming. Let’s explore some top-rated providers and ways to compare plans:

  1. Blue Cross Blue Shield: Offers plans in 47 states and provides additional benefits such as dental, vision, hearing, lifestyle, and transportation. Their plans have an aggregate rating of 4.17 out of 5 from the Centers for Medicare and Medicaid Services (CMS) 1.
  1. Humana: Covers all 50 states and includes extra benefits like dental, vision, hearing, lifestyle, and transportation. Their plans have an aggregate rating of 4.02 out of 5 from CMS 1.
  1. Aetna: Also available in all 50 states, Aetna offers additional benefits like dental, vision, hearing, lifestyle, and transportation. Their plans have an aggregate rating of 3.87 out of 5 from CMS 1.

To compare Medicare Advantage plans side by side, you can use online tools like the Plan Finder to evaluate costs, benefits, and additional features. This way, you can confidently choose the right plan for your unique situation 23. Remember that your choice should be personalized based on your ZIP code, demographic information, and specific health needs.

Feel free to explore these providers further and find the plan that best suits your requirements!

Tuesday, March 12, 2024

 

 


 

If you live in FLORIDA and you have MEDICARE PARTS A and B, you may qualify to  

Receive Up to a $145 INCREASE to your Social Security Check MONTHLY with this Medicare Advantage plan.

 

 

PLUS,

Monthly premium

$0.00 

 
Medical deductible
$0
 
Prescription drug deductibles
$0

Annual plan premiums

$0 ($0.00 premium x 12 months)

Maximum Out-of-Pocket

In-Network
Maximum out-of-pocket responsibility
$4,000
 
The out-of-pocket maximum is the maximum amount that you will be required to pay a year for deductibles, copayments, and coinsurance on covered services. It does not include the amount you pay for monthly premiums.
 
 

Covered Doctor Copays

In-Network
Primary care copay
$0 copay
 
Specialist copay
$40 copay
 
 
1,000 participating providers
 

Prescription Drug Costs & Coverage

 

Important Message About What You Pay for Vaccines - Our Medicare Advantage Prescription Drug plans cover most Part D vaccines* at no additional cost to you, even if your plan has a deductible and you haven’t paid it.

Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month (up to 30-day) supply of each Part D insulin product covered by the plan, no matter what cost-sharing tier it’s on, even if your plan has a deductible and you haven’t paid it.

 

Retail Pharmacies include:

 
CVS PHARMACY
WALGREENS PHARMACY
WINN DIXIE PHARMACY
PUBLIX PHARMACY
WALMART PHARMACY and MORE

 

Initial Coverage Stage

You pay the initial coverage costs below until your total yearly drug costs reach $5,030. Total yearly drug costs are the total drug costs paid by both you and CarePlus. Once you reach $5,030, you will enter the coverage gap (Coverage Gap Stage).
 
Tier 1 – Preferred Generic
$0 copay
 
Tier 2 – Generic
$5 copay
 
Tier 3 – Preferred Brand
$45 copay
 
Tier 4 – Non-Preferred Drug
$85 copay
 
Tier 5 – Specialty Tier
33% coinsurance

Coverage Gap Stage

After you enter the coverage gap, you pay 25 percent of the plan’s cost for covered brand name drugs and 25 percent of the plan’s cost for covered generic drugs until your costs total $8,000 — which is the end of the coverage gap. Not everyone will enter the coverage gap. See Evidence of Coverage for complete details.

Catastrophic Coverage Stage

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $8,000, you pay the greater of:
  • 0% of the cost, or
  • $0.00 copay for generic (including brand drugs treated as generic) and a $0.00 copayment for all other drugs

 

Hospital & Urgent Care

In-Network
Inpatient hospital care
$225 copay per day for day 1 to 7
$0 copay per day for day 8 to 90
 
Outpatient surgery at hospital
$200 copay
 
Outpatient surgery at surgical center
$200 copay
 
Emergency room
If you are admitted to the hospital within 24 hours, you do not have to pay your share of the cost for the emergency care.
$120 copay
 
Urgent care
Urgently needed services are provided to treat a non-emergency, unforeseen medical illness, injury or condition that requires immediate medical attention.
$40 copay
 

Labs & X-Rays

In-Network
Cost share may vary depending on the service and where service is provided.
Diagnostic procedures/tests
$0-$200 copay
 
Lab services
$0 copay
 
Diagnostic radiological services
$125-$200 copay
 
X-ray services
$0-$125 copay
 

 
$0 Copays for: 
 

Routine vision coverage

Routine dental coverage

Routine hearing coverage

Meal delivery service

OTC Allowance $25 per month

SilverSneakers® fitness program 

Transportation

Annual Flex Allowance of $250 on a prepaid card

 

Mental Health Services

In-Network
Inpatient care at a psychiatric facility
Your plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital.
$225 copay per day for day 1 to 7
$0 copay per day for day 8 to 90
 
Outpatient group and individual therapy visits
Cost share may vary depending on where service is provided
$30 copay
 

Dental Benefits

In-Network
Medicare-covered dental services
$40 copay
 
Routine Dental
Bitewing x-rays up to 1 set(s) per year
$0 copay
 
Periodic oral exam up to 2 per year
$0 copay
 
Prophylaxis (cleaning) up to 2 per year
$0 copay
 
Amalgam and/or composite filling up to unlimited per year
$0 copay
 
Comprehensive oral evaluation or periodontal exam up to 1 every 3 years
$0 copay
 
Simple or surgical extraction up to unlimited per year
$0 copay
 
Necessary anesthesia with covered service up to unlimited per year
$0 copay
 
Maximum benefit
$2,000 maximum benefit coverage amount per year
 

Vision Benefits

In-Network
Medicare-covered vision services
$40 copay
 
Diabetic eye exam
$0 copay
 
Glaucoma screening
$0 copay
 
Eyewear (post cataract surgery)
$0 copay
 
Routine Vision
Routine exam up to 1 per year
$0 copay
 
Contact lenses up to unlimited pair(s) per year
$0 copay
 
Eyeglasses-lenses and frames up to unlimited pair(s) per year
$0 copay
 
Fitting for eyeglasses-lenses and frames up to unlimited per year
$0 copay
 
Refraction up to 1 per year
$0 copay
 
Max benefits: contact lenses, eyeglasses-lenses and frames, fitting for eyeglasses-lenses and frames
$150 maximum benefit coverage amount per year
 
Additional notes
$0 copayment for refraction and dilation (if necessary) with routine exam up to 1 per year. $150 maximum benefit coverage amount per year for contact lenses or eyeglasses-lenses and frames plus fitting; or, 1 pair of select eyeglasses at no cost. Eyeglasses include ultraviolet protection and scratch resistant coating.
 

Hearing Benefits

In-Network
Medicare-covered hearing services
$40 copay
 
Routine Hearing
Fitting/evaluation up to 1 per year
$0 copay
 
Routine hearing exams up to 1 per year
$0 copay
 
Hearing aids (all types) up to 1 per ear per year
$250 maximum benefit coverage amount per ear per year
 

Preventive Benefits

In-network: $0 for the following preventive services when you see an in-network provider:
  • Bone mass measurement
  • Annual wellness visit
  • Breast cancer screening (mammogram)
  • Cardiovascular screenings
  • Cervical and vaginal cancer screening
  • Colorectal cancer screening
  • Diabetes screening
  • Immunizations
  • Lung cancer screening
  • Medicare diabetes prevention program (MDPP)
  • Prostate cancer screening exam
  • Routine physical exams

 

This Plan Becomes Effective The 1st of the Month following your enrollment

 

CLICK THE LINK BELOW TO ENROLL ONLINE


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  Certainly!   Medicare Advantage   (also known as   Medicare Part C ) is a popular form of health insurance coverage for U.S. adults aged 6...