July 22, 2020
Star RatingPremium$0Part B GivebackYesPCP in-network$5Specialist in-network$50Inpatient Hospital$390 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$50- $275: SURMedical Deductible$0MOOP in-network$7,500 Rx Deductible$150Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 22, 2020
Star RatingNot AvailablePremium$0Part B GivebackNoPCP in-network$0Specialist in-network$20Inpatient Hospital$250 (days 1-4) ; $0 (days 5-90)Outpatient Hospital Services$20- $250: SURMedical Deductible$0MOOP in-network$4,500 Rx Deductible​$0Prescription drug coverage (at preferred continue reading
July 22, 2020
Star RatingNot AvailablePremium$0Part B GivebackNoPCP in-network$0Specialist in-network$25Inpatient Hospital$325 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$25- $325: SURMedical Deductible$0MOOP in-network$5,500 Rx Deductible​$0Prescription drug coverage (at preferred continue reading
July 22, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$30Inpatient Hospital$300 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$30- $245: SURMedical Deductible$0MOOP in-network$6,500 Rx DeductibleN/APrescription drug coverage (at preferred pharmacies)Tier continue reading
July 17, 2020
Premium Part B Giveback $0 IN/OON Total Premium (Part C Part D) $0 IN/OON In-Network Plan Deductible N/A IN/OON MOOP $5,550 IN/OON Inpatient Hospital - Acute continue reading
July 17, 2020
Premium$0Part B Giveback$75Total Premium (Part C Part D)$0 IN/OONIn-Network Plan Deductible$200 IN/OONMOOP$7,550 IN/OONInpatient Hospital - Acute$325 (days 1-6) ; $0 (days 7-90) IN; 20% of the continue reading
July 17, 2020
Premium Part B Giveback $0 IN/OON Total Premium (Part C Part D) $0 IN/OON In-Network Plan Deductible N/A IN/OON MOOP $5,550 IN/OON Inpatient Hospital - Acute continue reading
July 17, 2020
Premium Part B Giveback $0 IN/OON Total Premium (Part C Part D) $20.90 IN/OON In-Network Plan Deductible N/A IN/OON MOOP $6,000 IN/OON Inpatient Hospital - Acute continue reading
July 17, 2020
Premium Part B Giveback $0 Total Premium (Part C Part D) $0 In-Network Plan Deductible $0 MOOP $3,450 Inpatient Hospital - Acute ​$0 copay up to continue reading
July 17, 2020
Premium Part B Giveback $0 IN/OON Total Premium (Part C Part D) $0 IN/OON In-Network Plan Deductible $0 IN/OON MOOP $3,450 IN/OON Inpatient Hospital - Acute continue reading
July 17, 2020
Premium Part B Giveback $0 Total Premium (Part C Part D) $0 In-Network Plan Deductible N/A MOOP $5,500 Inpatient Hospital - Acute $350 (days 1-5) ; continue reading
July 17, 2020
Premium Part B Giveback $0 Total Premium (Part C Part D) $0 In-Network Plan Deductible N/A MOOP $5,500 Inpatient Hospital - Acute $350 (days 1-5 ) continue reading
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