Medicare Advantage Plan Benefit Details in Plain Text|
|The following Medicare Advantage plan benefits apply to the Cigna-HealthSpring TotalCare (HMO SNP) plan (H3949 - 009) in Bucks, Pennsylvania only.
To switch to a different Medicare Advantage plan or to change your location, click here.|
Click here to see this information for the Cigna-HealthSpring TotalCare (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.|
|The Cigna-HealthSpring TotalCare (HMO SNP) plan has a monthly premium of $30.40. That is $364.80 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 $30.40 montly premium is in addition to your Medicare Part B premium.|
|This Medicare Advantage Plan with Prescription Drug Coverage is a Local HMO plan.|
|Plan Membership and Plan Ratings|
|The Cigna-HealthSpring TotalCare (HMO SNP) plan currently has 29,452 members in Bucks county. The Centers for Medicare and Medicaid Services (CMS) has has given this plan carrier a summary rating of 3.50 stars. The detail CMS plan carrier ratings are as follows: a Customer Service Rating of 2 out of 5 stars , a Member Experience Rating of 2 out of 5 stars, and a Drug Cost Information Accuracy Rating of 2 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 Cigna-HealthSpring TotalCare (HMO SNP) plan will share the costs of your medications with you. (See cost-sharing below). $310.00 is the maximum deductible for 2014. There are other plans with a lower deductible or even a $0 deductible.|
|The following information is about the Cigna-HealthSpring TotalCare (HMO SNP) formulary (or drug list). There are 2946 drugs on the Cigna-HealthSpring TotalCare (HMO SNP) formulary. Click here to browse the Cigna-HealthSpring TotalCare (HMO SNP) 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 $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 Cigna-HealthSpring TotalCare (HMO SNP) plan’s formulary is divided into 1 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 contains drugs. The tier 1 co-insurance is 15% of the drug costs. Click here to browse the Cigna-HealthSpring TotalCare (HMO SNP) 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 21% 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 2.5% of the cost of your brand-name drugs pruchased in the Donut Hole. 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 (Cigna-HealthSpring TotalCare (HMO SNP)) offers No Coverage during the Coverage Gap phase.|
|The Cigna-HealthSpring TotalCare (HMO SNP) plan offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail.|