Star RatingNot AvailableMedicare Zero Dollar Cost SharingYesPCP0%Specialist in-network0%MOOP in-network$7,550 Rx Deductible$220Copayments may vary depending on your level of ExtraHelp®Tier 1: Preferred Generics (standard) : $5Tier 1: continue reading
2021
July 23, 2020
Star RatingPremium$99Part B GivebackNoPCP in-network$25Specialist in-network$50Inpatient Hospital$300 (days 1-7) ; $0 (days 8-90)Outpatient Hospital Services$50 - $325: SURMedical Deductible$1,000MOOP in-network$7,550 Rx Deductible$0Prescription drug coverage (at preferred continue reading
July 23, 2020
Star RatingPremium$69Part B GivebackNoPCP in-network$20Specialist in-network$50Inpatient Hospital$315 (days 1-7) ; $0 (days 8-90)Outpatient Hospital Services$50 - $325: SURMedical Deductible$1,000MOOP in-network$7,550 Rx Deductible$250Prescription drug coverage (at preferred continue reading
July 23, 2020
Star RatingPremium$53Part B GivebackNoPCP in-network$25Specialist in-network$50Inpatient Hospital$300 (days 1-7) ; $0 (days 8-90)Outpatient Hospital Services$50 - $325: SURMedical Deductible$1,000MOOP in-network$7,550 Rx Deductible$150Prescription drug coverage (at preferred continue reading
July 23, 2020
Star Rating Premium $47 Part B Giveback No PCP in-network $10 Specialist in-network $50 Inpatient Hospital $300 (days 1-7) ; $0 (days 8-90) Outpatient Hospital Services continue reading
July 23, 2020
Star Rating Premium $33 Part B Giveback No PCP in-network $0 Specialist in-network $50 Inpatient Hospital $300 (days 1-7) ; $0 (days 8-90) Outpatient Hospital Services continue reading
July 23, 2020
Star RatingPremium$25Part B GivebackNoPCP in-network$25Specialist in-network$50Inpatient Hospital$300 (days 1-6) ; $0 (days 7-90)Outpatient Hospital Services$275Medical Deductible$0MOOP in-network$6,700 Rx Deductible$250Prescription drug coverage (at preferred pharmacies)Tier 1: Preferred continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$50Inpatient Hospital$335 (days 1-6) ; $0 (days 7-90)Outpatient Hospital Services$325Medical Deductible$0MOOP in-network$7,550 Rx Deductible$195Prescription drug coverage (at preferred pharmacies)Tier 1: Preferred continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$45Inpatient Hospital$280 (days 1-6) ; $0 (days 7-90)Outpatient Hospital Services$245Medical Deductible$0MOOP in-network$6,700 Rx Deductible$195Prescription drug coverage (at preferred pharmacies)Tier 1: Preferred continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$50Inpatient Hospital$275 (days 1-6) ; $0 (days 7-90)Outpatient Hospital Services$50- $240: SURMedical Deductible$0MOOP in-network$7,550 Rx DeductibleN/APrescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$50Inpatient Hospital$300 (days 1-7) ; $0 (days 8-90)Outpatient Hospital Services$325Medical Deductible$0MOOP in-network$6,700 Rx Deductible$195Prescription drug coverage (at preferred pharmacies)Tier 1: Preferred continue reading
July 23, 2020
Star Rating Premium $0 Part B Giveback No PCP in-network $0 Specialist in-network $50 Inpatient Hospital $300 (days 1-7) ; $0 (days 8-90) Outpatient Hospital Services continue reading
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TMG University
