July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$40Inpatient Hospital$279 (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 RatingNot AvailablePremium$22Part B GivebackNoPCP in-network$0Specialist in-network$25Inpatient Hospital$300 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$25- $300: SURMedical Deductible$0MOOP in-network$7,500 Rx Deductible$250Prescription drug coverage (at preferred continue reading
July 23, 2020
Star RatingNot AvailablePremium$20Part B GivebackNoPCP in-network$0Specialist in-network$25Inpatient Hospital$300 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$25- $300: SURMedical Deductible$0MOOP in-network$6,700 Rx Deductible$250Prescription drug coverage (at preferred continue reading
July 23, 2020
Star RatingPremium$15Part B GivebackNoPCP in-network$0Specialist in-network$20Inpatient Hospital$275 (days 1-6) ; $0 (days 7-90)Outpatient Hospital Services$20- $275: SURMedical Deductible$0MOOP in-network$5,900 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackYesPCP in-network$10Specialist in-network$45Inpatient Hospital$350 (days 1-4) ; $0 (days 6-90)Outpatient Hospital Services$45- $350: SURMedical Deductible$0MOOP in-network$7,500 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$0Specialist in-network$40Inpatient Hospital$350 (days 1-4) ; $0 (days 6-90)Outpatient Hospital Services$40- $300: SURMedical Deductible$0MOOP in-network$6,700 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackNoPCP in-network$5Specialist in-network$45Inpatient Hospital$300 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$45- $275: SURMedical Deductible$0MOOP in-network$7,500 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackN/APCP in-network$0Specialist in-network$35Inpatient Hospital$350 (days 1-4) ; $0 (days 5-90)Outpatient Hospital Services$35- $300: SURMedical Deductible$0MOOP in-network$6,700 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star RatingPremium$0Part B GivebackYesPCP in-network$0Specialist in-network$40Inpatient Hospital$350 (days 1-4) ; $0 (days 5-90)Outpatient Hospital Services$40- $300: SURMedical Deductible$0MOOP in-network$7,500 Rx Deductible$0Prescription drug coverage (at preferred pharmacies)Tier continue reading
July 23, 2020
Star Rating Premium $32 Part B Giveback No PCP in-network $0 Specialist in-network $20 Inpatient Hospital $275 (days 1-6) ; $0 (days 7-90) Outpatient Hospital Services continue reading
July 23, 2020
Star Rating Not Available Premium $21 Part B Giveback No PCP in-network $0 Specialist in-network $25 Inpatient Hospital $300 (days 1-5) ; $0 (days 6-90) Outpatient continue reading
July 23, 2020
Star RatingPremium$16Part B GivebackNoPCP in-network$0Specialist in-network$30Inpatient Hospital$380 (days 1-5) ; $0 (days 6-90)Outpatient Hospital Services$35- $275: SURMedical Deductible$0MOOP in-network$6,700 Rx Deductible$150Prescription drug coverage (at preferred pharmacies)Tier continue reading
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