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Description of the Evercare Plan DH (HMO SNP) plan (H5253 - 024) in Green Lake, Wisconsin



Medicare Advantage Plan Benefit Details in Plain Text
The following Medicare Advantage plan benefits apply to the Evercare Plan DH (HMO SNP) plan (H5253 - 024) in Green Lake, Wisconsin only.   To switch to a different Medicare Advantage plan or to change your location, click here.
Click here to see this information for the Evercare Plan DH (HMO SNP) plan in a chart format along with the plan enrollment options. We will also send a copy of the plan benefit details chart to your email account.

Plan Premium
The Evercare Plan DH (HMO SNP) plan has a monthly premium of $27.70. That is $332.40 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher. Please remember that the $27.70 montly premium is in addition to your Medicare Part B premium.

This Medicare Advantage Plan with Prescription Drug Coverage is a Local HMO plan. Since this plan is a Special Needs Plan (SNP), only people who meet the eligibility requirement are permitted to enroll in the plan. The eligiblity requirement for this plan is Dual-Eligible. The features of a SNP plan are made to better serve people who meet the eligiblity requirements.

Plan Membership and Plan Ratings
The Evercare Plan DH (HMO SNP) plan a new plan in Green Lake county, therefore we do not yet have membership figures.and The Centers for Medicare and Medicaid Services (CMS) has rated the plan carrier as follows: a Customer Service Rating of 4 out of 5 stars a Member Experience Rating of 4 out of 5 stars a Drug Cost Information Accuracy Rating of 4 out of 5 stars.

Prescription Drug Coverage: Deductible, Cost-sharing, Formulary
This plan has a $310.00 deductible. That means that you are 100% responsible for the first $310.00 in medication costs and after that is met, the Evercare Plan DH (HMO SNP) plan will share the costs of your medications with you. (See cost-sharing below). $310.00 is the maximum deductible for 2011. There are other plans with a lower deductible or even a $0 deductible.
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $310.00, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Evercare Plan DH (HMO SNP) plan’s formulary is divided into tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan has not yet been released by CMS. We expect to have the cost-sharing information mid-October.
The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 7% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug pharmceutical company will pay 50% of the cost of your brand-name drugs pruchased in the donut hole on your behalf. Since the brand-name drug manufacturer pays on your behalf, the portion that they pay counts toward your TrOOP (or True Out of Pocket) costs. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Coverage". This plan (Evercare Plan DH (HMO SNP)) offers No Coverage during the Coverage Gap phase.
The Evercare Plan DH (HMO SNP) plan offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail.

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