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This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2016 HumanaChoice H1418-007 (PPO) in Richland, Illinois

Medicare Advantage Plan Benefit Details in Plain Text
The following Medicare Advantage plan benefits apply to the HumanaChoice H1418-007 (PPO) (H1418 - 007) in Richland, Illinois .

This plan is administered by HUMANA INSURANCE COMPANY.  To switch to a different Medicare Advantage plan or to change your location, click here.
Click here to see the HumanaChoice H1418-007 (PPO) health and prescription benefit details in chart format or email and view benefits chart

Plan Premium
The HumanaChoice H1418-007 (PPO) has a monthly premium of $101.00. That is $1,212.00 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 $101.00 montly premium is in addition to your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA).

This Medicare Advantage Plan with Prescription Drug Coverage is a Local PPO plan.

Plan Membership and Plan Ratings
The HumanaChoice H1418-007 (PPO) (H1418 - 007) currently has 1,737 members. There are 55 members enrolled in this plan in Richland, Illinois, and 1,700 members in Illinois.

The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings are as follows:
Prescription Drug Coverage: Deductible, Cost-sharing, Formulary
This plan has a $360 deductible. So, you are 100% responsible for the first $360 in medication costs. After you have met the deductible, the HumanaChoice H1418-007 (PPO) will share the costs of your medications with you -- see cost-sharing below. $360 is the maximum deductible for 2016. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible.

The following information is about the HumanaChoice H1418-007 (PPO) formulary (or drug list). There are 3615 drugs on the HumanaChoice H1418-007 (PPO) formulary. Click here to browse the HumanaChoice H1418-007 (PPO) Formulary.
 
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 $360, 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 HumanaChoice H1418-007 (PPO)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows:
  • Tier 1 (Preferred Generic) contains 247 drugs and has a co-payment of $6.00.
  • Tier 2 (Generic) contains 778 drugs and has a co-payment of $15.00.
  • Tier 3 (Preferred Brand) contains 841 drugs and has a co-payment of $47.00.
  • Tier 4 (Non-Preferred Brand) contains 1,431 drugs and has a co-payment of $100.00.
  • Tier 5 (Specialty Tier) contains 587 drugs and has a co-insurance of 25% of the drug cost.
  •  
Click here to browse the HumanaChoice H1418-007 (PPO) Formulary.

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 42% of your generic drug prescription costs in the donut hole on your behalf.

The brand-name drug manufacturer will pay 50% and your plan will pay an additional 5% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 55% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. 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 Gap Coverage". This plan (HumanaChoice H1418-007 (PPO)) offers Coverage in the gap, however Medicare has not specified the details of the gap coverage.

The HumanaChoice H1418-007 (PPO) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail.

** Cost **
Monthly premium, deductible, and limits on how much you pay for covered services
$101 per month. In addition you must keep paying your Medicare Part B premium.
$360 per year for Part D prescription drugs except for drugs listed on Tier 1 and Tier 2 which are excluded from the deductible.
Yes. Like all Medicare health plans our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care.
Your yearly limit(s) in this plan:
  • $6 700 for services you receive from in-network providers.
  • $10 000 for services you receive from any provider. Your limit for services received from in-network providers will count toward this limit.
If you reach the limit on out-of-pocket costs you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year.

Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs.
Our plan has a coverage limit every year for certain benefits from any provider. Contact us for services that apply.
** Doctor and Hospital Choice **
Acupuncture
Not covered
** Extra Benefits **
Inpatient mental health care
For inpatient mental health care see the "Mental Health Care" section.
Outpatient prescription drugs
For Part B drugs such as chemotherapy drugs1:
  • In-network:  20% of the cost
  • Out-of-network:  50% of the cost
Other Part B drugs1:
  • In-network:  20% of the cost
  • Out-of-network:  50% of the cost
After you pay your yearly deductible you pay the following until your total yearly drug costs reach $3 310. Total yearly drug costs are the total drug costs paid by both you and our Part D plan.
You may get your drugs at network retail pharmacies and mail order pharmacies.
Standard Retail Cost-Sharing
TierOne-month supplyThree-month supply
Tier 1 (Preferred Generic)$6 copay$18 copay
Tier 2 (Generic)$15 copay$45 copay
Tier 3 (Preferred Brand)$47 copay$141 copay
Tier 4 (Non-Preferred Brand)$100 copay$300 copay
Tier 5 (Specialty Tier)25% of the costNot Offered
Standard Mail Order Cost-Sharing
TierOne-month supplyThree-month supply
Tier 1 (Preferred Generic)$6 copay$18 copay
Tier 2 (Generic)$15 copay$45 copay
Tier 3 (Preferred Brand)$47 copay$141 copay
Tier 4 (Non-Preferred Brand)$100 copay$300 copay
Tier 5 (Specialty Tier)25% of the costNot Offered
Preferred Mail Order Cost-Sharing
TierOne-month supplyThree-month supply
Tier 1 (Preferred Generic)$6 copay$0
Tier 2 (Generic)$15 copay$0
Tier 3 (Preferred Brand)$47 copay$131 copay
Tier 4 (Non-Preferred Brand)$100 copay$290 copay
Tier 5 (Specialty Tier)25% of the costNot Offered
If you reside in a long-term care facility you pay the same as at a retail pharmacy.
You may get drugs from an out-of-network pharmacy but may pay more than you pay at an in-network pharmacy.
Most Medicare drug plans have a coverage gap (also called the "donut hole"). This means that there's a temporary change in what you will pay for your drugs. The coverage gap begins after the total yearly drug cost (including what our plan has paid and what you have paid) reaches $3 310.

After you enter the coverage gap you pay 45% of the plan's cost for covered brand name drugs and 58% of the plan's cost for covered generic drugs until your costs total $4 850 which is the end of the coverage gap. Not everyone will enter the coverage gap.

Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.
Standard Retail Cost-Sharing
TierDrugs CoveredOne-month supplyThree-month supply
Tier 1 (Preferred Generic)Some$6 copay$18 copay
Tier 2 (Generic)Some$15 copay$45 copay
Tier 3 (Preferred Brand)Some$47 copay$141 copay
Tier 4 (Non-Preferred Brand)Some$100 copay$300 copay
Tier 5 (Specialty Tier)Some25% of the costNot Offered
Standard Mail Order Cost-Sharing
TierDrugs CoveredOne-month supplyThree-month supply
Tier 1 (Preferred Generic)Some$6 copay$18 copay
Tier 2 (Generic)Some$15 copay$45 copay
Tier 3 (Preferred Brand)Some$47 copay$141 copay
Tier 4 (Non-Preferred Brand)Some$100 copay$300 copay
Tier 5 (Specialty Tier)Some25% of the costNot Offered
Preferred Mail Order Cost-Sharing
TierDrugs CoveredOne-month supplyThree-month supply
Tier 1 (Preferred Generic)Some$6 copay$0
Tier 2 (Generic)Some$15 copay$0
Tier 3 (Preferred Brand)Some$47 copay$131 copay
Tier 4 (Non-Preferred Brand)Some$100 copay$290 copay
Tier 5 (Specialty Tier)Some25% of the costNot Offered
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $4 850 you pay the greater of:
  • 5% of the cost or
  • $2.95 copay for generic (including brand drugs treated as generic) and a $7.40 copayment for all other drugs.
** Important Information **
Monthly premium, deductible, and limits on how much you pay for covered services
$101 per month. In addition you must keep paying your Medicare Part B premium.
$360 per year for Part D prescription drugs except for drugs listed on Tier 1 and Tier 2 which are excluded from the deductible.
Yes. Like all Medicare health plans our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care.
Your yearly limit(s) in this plan:
  • $6 700 for services you receive from in-network providers.
  • $10 000 for services you receive from any provider. Your limit for services received from in-network providers will count toward this limit.
If you reach the limit on out-of-pocket costs you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year.

Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs.
Our plan has a coverage limit every year for certain benefits from any provider. Contact us for services that apply.
** Outpatient Care and Services **
Acupuncture
Not covered
Ambulance
  • In-network:  $300 copay
  • Out-of-network:  $300 copay
Chiropractic care
Manipulation of the spine to correct a subluxation (when 1 or more of the bones of your spine move out of position):
  • In-network:  $15 copay
  • Out-of-network:  50% of the cost
Dental services
Limited dental services (this does not include services in connection with care treatment filling removal or replacement of teeth):
  • In-network:  $45 copay
  • Out-of-network:  50% of the cost
Preventive dental services:
  • Cleaning (for up to 1 every year):
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
  • Dental x-ray(s) (for up to 1 every year):
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
  • Oral exam (for up to 1 every year):
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
    Diabetes supplies and services
    Diabetes monitoring supplies:
    • In-network:  0-20% of the cost depending on the supply
    • Out-of-network:  50% of the cost
    Diabetes self-management training:
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
    Therapeutic shoes or inserts:
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
    Diagnostic tests, lab and radiology services, and x-rays (Costs for these services may be different if received in an outpatient surgery setting)
    Diagnostic radiology services (such as MRIs CT scans):
    • In-network:  $15-279 copay depending on the service
    • Out-of-network:  50% of the cost
    Diagnostic tests and procedures:
    • In-network:  $0-95 copay depending on the service
    • Out-of-network:  50% of the cost
    Lab services:
    • In-network:  $0-45 copay depending on the service
    • Out-of-network:  50% of the cost
    Outpatient x-rays:
    • In-network:  $15-95 copay depending on the service
    • Out-of-network:  50% of the cost
    Therapeutic radiology services (such as radiation treatment for cancer):
    • In-network:  20% of the cost
    • Out-of-network:  50% of the cost
    Doctor's office visits
    Primary care physician visit:
    • In-network:  $15 copay
    • Out-of-network:  50% of the cost
    Specialist visit:
    • In-network:  $45 copay
    • Out-of-network:  50% of the cost
    Durable medical equipment (wheelchairs, oxygen, etc.)
    • In-network:  15% of the cost
    • Out-of-network:  45% of the cost
    If you go to a preferred vendor your cost may be less. Contact us for a list of preferred vendors.
    Emergency care
    $75 copay
    If you are admitted to the hospital within 24 hours you do not have to pay your share of the cost for emergency care. See the "Inpatient Hospital Care" section for other costs.
    Foot care (podiatry services)
    Foot exams and treatment if you have diabetes-related nerve damage and/or meet certain conditions:
    • In-network:  $45 copay
    • Out-of-network:  50% of the cost
    Routine foot care (for up to 2 visit(s) every year):
    • In-network:  $45 copay
    • Out-of-network:  50% of the cost
    Hearing services
    Exam to diagnose and treat hearing and balance issues:
    • In-network:  $45 copay
    • Out-of-network:  50% of the cost
    Routine hearing exam (for up to 1 every year):
    • In-network:  $30 copay
    • Out-of-network:  $35 copay
    Home health care
    • In-network:  You pay nothing
    • Out-of-network:  50% of the cost
    Mental health care
    Inpatient visit:
    Our plan covers up to 190 days in a lifetime for inpatient mental health care in a psychiatric hospital. The inpatient hospital care limit does not apply to inpatient mental services provided in a general hospital.
    Our plan covers 90 days for an inpatient hospital stay.
    Our plan also covers 60 "lifetime reserve days." These are "extra" days that we cover. If your hospital stay is longer than 90 days you can use these extra days. But once you have used up these extra 60 days your inpatient hospital coverage will be limited to 90 days.
    • In-network:  
      • $223 copay per day for days 1 through 7
      • You pay nothing per day for days 8 through 90
        • Out-of-network:  
          • 50% of the cost per stay
          • Outpatient group therapy visit:
            • In-network:  $40 copay
            • Out-of-network:  50% of the cost
            Outpatient individual therapy visit:
            • In-network:  $40 copay
            • Out-of-network:  50% of the cost
            Outpatient rehabilitation
            Cardiac (heart) rehab services (for a maximum of 2 one-hour sessions per day for up to 36 sessions up to 36 weeks):
            • In-network:  $15 copay
            • Out-of-network:  50% of the cost
            Occupational therapy visit:
            • In-network:  $40 copay
            • Out-of-network:  50% of the cost
            Physical therapy and speech and language therapy visit:
            • In-network:  $40 copay
            • Out-of-network:  50% of the cost
            Outpatient substance abuse
            Group therapy visit:
            • In-network:  $40-95 copay depending on the service
            • Out-of-network:  50% of the cost
            Individual therapy visit:
            • In-network:  $40-95 copay depending on the service
            • Out-of-network:  50% of the cost
            Outpatient surgery
            Ambulatory surgical center:
            • In-network:  $229 copay
            • Out-of-network:  50% of the cost
            Outpatient hospital:
            • In-network:  $279 copay
            • Out-of-network:  50% of the cost
            Over-the-counter items
            Please visit our website to see our list of covered over-the-counter items.
            Prosthetic devices (braces, artificial limbs, etc.)
            Prosthetic devices:
            • In-network:  20% of the cost
            • Out-of-network:  50% of the cost
            Related medical supplies:
            • In-network:  20% of the cost
            • Out-of-network:  50% of the cost
            Renal dialysis
            • In-network:  20% of the cost
            • Out-of-network:  20% of the cost
            Transportation
            Not covered
            Urgently needed services
            $15-45 copay or 50% of the cost (up to $65) depending on the service
            Vision services
            Exam to diagnose and treat diseases and conditions of the eye (including yearly glaucoma screening):
            • In-network:  $0-45 copay depending on the service
            • Out-of-network:  50% of the cost
            Routine eye exam (for up to 1 every year):
            • In-network:  You pay nothing
            • Out-of-network:  You pay nothing
            Our plan pays up to $40 every year for routine eye exams from any provider.
            Eyeglasses or contact lenses after cataract surgery:
            • In-network:  You pay nothing
            • Out-of-network:  You pay nothing
            ** Hospice **
            Hospice
            You pay nothing for hospice care from a Medicare-certified hospice. You may have to pay part of the cost for drugs and respite care.
            ** Preventive Care **
            Preventive care
            • In-network:  You pay nothing
            • Out-of-network:  0-50% of the cost depending on the service
            Our plan covers many preventive services including:
            • Abdominal aortic aneurysm screening
            • Alcohol misuse counseling
            • Bone mass measurement
            • Breast cancer screening (mammogram)
            • Cardiovascular disease (behavioral therapy)
            • Cardiovascular screenings
            • Cervical and vaginal cancer screening
            • Colorectal cancer screenings (Colonoscopy Fecal occult blood test Flexible sigmoidoscopy)
            • Depression screening
            • Diabetes screenings
            • HIV screening
            • Medical nutrition therapy services
            • Obesity screening and counseling
            • Prostate cancer screenings (PSA)
            • Sexually transmitted infections screening and counseling
            • Tobacco use cessation counseling (counseling for people with no sign of tobacco-related disease)
            • Vaccines including Flu shots Hepatitis B shots Pneumococcal shots
            • "Welcome to Medicare" preventive visit (one-time)
            • Yearly "Wellness" visit
            Any additional preventive services approved by Medicare during the contract year will be covered.
            ** Inpatient Care **
            Inpatient hospital care
            Our plan covers an unlimited number of days for an inpatient hospital stay.
            • In-network:  
              • $279 copay per day for days 1 through 7
              • You pay nothing per day for days 8 through 90
              • You pay nothing per day for days 91 and beyond
                • Out-of-network:  
                  • 50% of the cost per stay
                  • Inpatient mental health care
                    For inpatient mental health care see the "Mental Health Care" section.
                    Skilled Nursing Facility (SNF)
                    Our plan covers up to 100 days in a SNF.
                    • In-network:  
                      • You pay nothing per day for days 1 through 20
                      • $160 copay per day for days 21 through 100
                        • Out-of-network:  
                          • 50% of the cost per stay
                          • Outpatient prescription drugs
                            For Part B drugs such as chemotherapy drugs1:
                            • In-network:  20% of the cost
                            • Out-of-network:  50% of the cost
                            Other Part B drugs1:
                            • In-network:  20% of the cost
                            • Out-of-network:  50% of the cost
                            After you pay your yearly deductible you pay the following until your total yearly drug costs reach $3 310. Total yearly drug costs are the total drug costs paid by both you and our Part D plan.
                            You may get your drugs at network retail pharmacies and mail order pharmacies.
                            Standard Retail Cost-Sharing
                            TierOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)$6 copay$18 copay
                            Tier 2 (Generic)$15 copay$45 copay
                            Tier 3 (Preferred Brand)$47 copay$141 copay
                            Tier 4 (Non-Preferred Brand)$100 copay$300 copay
                            Tier 5 (Specialty Tier)25% of the costNot Offered
                            Standard Mail Order Cost-Sharing
                            TierOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)$6 copay$18 copay
                            Tier 2 (Generic)$15 copay$45 copay
                            Tier 3 (Preferred Brand)$47 copay$141 copay
                            Tier 4 (Non-Preferred Brand)$100 copay$300 copay
                            Tier 5 (Specialty Tier)25% of the costNot Offered
                            Preferred Mail Order Cost-Sharing
                            TierOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)$6 copay$0
                            Tier 2 (Generic)$15 copay$0
                            Tier 3 (Preferred Brand)$47 copay$131 copay
                            Tier 4 (Non-Preferred Brand)$100 copay$290 copay
                            Tier 5 (Specialty Tier)25% of the costNot Offered
                            If you reside in a long-term care facility you pay the same as at a retail pharmacy.
                            You may get drugs from an out-of-network pharmacy but may pay more than you pay at an in-network pharmacy.
                            Most Medicare drug plans have a coverage gap (also called the "donut hole"). This means that there's a temporary change in what you will pay for your drugs. The coverage gap begins after the total yearly drug cost (including what our plan has paid and what you have paid) reaches $3 310.

                            After you enter the coverage gap you pay 45% of the plan's cost for covered brand name drugs and 58% of the plan's cost for covered generic drugs until your costs total $4 850 which is the end of the coverage gap. Not everyone will enter the coverage gap.

                            Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.
                            Standard Retail Cost-Sharing
                            TierDrugs CoveredOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)Some$6 copay$18 copay
                            Tier 2 (Generic)Some$15 copay$45 copay
                            Tier 3 (Preferred Brand)Some$47 copay$141 copay
                            Tier 4 (Non-Preferred Brand)Some$100 copay$300 copay
                            Tier 5 (Specialty Tier)Some25% of the costNot Offered
                            Standard Mail Order Cost-Sharing
                            TierDrugs CoveredOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)Some$6 copay$18 copay
                            Tier 2 (Generic)Some$15 copay$45 copay
                            Tier 3 (Preferred Brand)Some$47 copay$141 copay
                            Tier 4 (Non-Preferred Brand)Some$100 copay$300 copay
                            Tier 5 (Specialty Tier)Some25% of the costNot Offered
                            Preferred Mail Order Cost-Sharing
                            TierDrugs CoveredOne-month supplyThree-month supply
                            Tier 1 (Preferred Generic)Some$6 copay$0
                            Tier 2 (Generic)Some$15 copay$0
                            Tier 3 (Preferred Brand)Some$47 copay$131 copay
                            Tier 4 (Non-Preferred Brand)Some$100 copay$290 copay
                            Tier 5 (Specialty Tier)Some25% of the costNot Offered
                            After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $4 850 you pay the greater of:
                            • 5% of the cost or
                            • $2.95 copay for generic (including brand drugs treated as generic) and a $7.40 copayment for all other drugs.
                            ** Outpatient Care **
                            Diabetes supplies and services
                            Diabetes monitoring supplies:
                            • In-network:  0-20% of the cost depending on the supply
                            • Out-of-network:  50% of the cost
                            Diabetes self-management training:
                            • In-network:  You pay nothing
                            • Out-of-network:  50% of the cost
                            Therapeutic shoes or inserts:
                            • In-network:  You pay nothing
                            • Out-of-network:  50% of the cost
                            Foot care (podiatry services)
                            Foot exams and treatment if you have diabetes-related nerve damage and/or meet certain conditions:
                            • In-network:  $45 copay
                            • Out-of-network:  50% of the cost
                            Routine foot care (for up to 2 visit(s) every year):
                            • In-network:  $45 copay
                            • Out-of-network:  50% of the cost
                            Hearing services
                            Exam to diagnose and treat hearing and balance issues:
                            • In-network:  $45 copay
                            • Out-of-network:  50% of the cost
                            Routine hearing exam (for up to 1 every year):
                            • In-network:  $30 copay
                            • Out-of-network:  $35 copay
                            ** Outpatient Medical Services and Supplies **
                            Outpatient substance abuse
                            Group therapy visit:
                            • In-network:  $40-95 copay depending on the service
                            • Out-of-network:  50% of the cost
                            Individual therapy visit:
                            • In-network:  $40-95 copay depending on the service
                            • Out-of-network:  50% of the cost
                            Prosthetic devices (braces, artificial limbs, etc.)
                            Prosthetic devices:
                            • In-network:  20% of the cost
                            • Out-of-network:  50% of the cost
                            Related medical supplies:
                            • In-network:  20% of the cost
                            • Out-of-network:  50% of the cost
                            ** Additional Benefits **
                            Inpatient mental health care
                            For inpatient mental health care see the "Mental Health Care" section.
                            ** Cost **
                            Monthly premium, deductible, and limits on how much you pay for covered services
                            Package 1: MyOption Vision
                            Benefits include:
                              • Eye Exams
                              • Eyewear
                            Additional $15.30 per month. You must keep paying your Medicare Part B premium and your $101 monthly plan premium.
                            This package does not have a deductible.
                            Our plan has a coverage limit for certain benefits.
                            ** Important Information **
                            Package 1: MyOption Vision
                            Benefits include:
                              • Eye Exams
                              • Eyewear
                            Additional $15.30 per month. You must keep paying your Medicare Part B premium and your $101 monthly plan premium.
                            This package does not have a deductible.
                            Our plan has a coverage limit for certain benefits.
                            ** Cost **
                            Package 2: MyOption Enhanced Dental PPO
                            Benefits include:
                              • Preventive Dental
                              • Comprehensive Dental
                            Additional $21.10 per month. You must keep paying your Medicare Part B premium and your $101 monthly plan premium.
                            This package does not have a deductible.
                            Our plan pays up to $1 500 every year. Our plan has additional coverage limits for certain benefits.
                            ** Important Information **
                            Package 2: MyOption Enhanced Dental PPO
                            Benefits include:
                              • Preventive Dental
                              • Comprehensive Dental
                            Additional $21.10 per month. You must keep paying your Medicare Part B premium and your $101 monthly plan premium.
                            This package does not have a deductible.
                            Our plan pays up to $1 500 every year. Our plan has additional coverage limits for certain benefits.





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                            • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
                            • Medicare has neither reviewed nor endorsed the information on our site.
                            • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
                            • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
                            • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
                            • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
                            • Limitations, copayments, and restrictions may apply.
                            • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
                              Statement required by Medicare:
                              "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
                            • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
                            • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
                            • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
                            • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
                            • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
                            • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
                            • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
                            • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
                            • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
                            • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
                            • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
                            • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
                            • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
                            • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
                            • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.