Premium $0 MOOP $4,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $275 (days 1-6) ; $0 (days 7-90)​ Ambulatory Surgery Center $0 continue reading
2021
July 8, 2020
Premium $14.70 MOOP $3,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $195 (days 1-6) ; $0 (days 7-90) IN ; 35% OON continue reading
July 8, 2020
Premium $29 MOOP $4,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $225 (days 1-6) ; $0 (days 7-90) IN ; 35% OON continue reading
July 8, 2020
Premium $0 MOOP $6,700 applies to in-network Medicare-covered benefits ; $10,000 applies to in-network and out-of-network Medicarecovered benefits combined PCP $5 IN ; $40 OON Specialist continue reading
July 8, 2020
Premium $29 MOOP $4,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $225 (days 1-6) ; $0 (days 7-90) IN ; 35% OON continue reading
July 8, 2020
Premium $0 MOOP $5,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $295 (days 1-6) ; $0 (days 7-90) IN ; 35% OON continue reading
July 8, 2020
Premium $13.20 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $195 (days 1-6) ; $0 (days 7-90) IN ; 35% OON continue reading
July 8, 2020
Premium $0 MOOP $4,900 applies to in-network Medicare-covered benefits ; $7,500 applies to in-network and out-of-network Medicarecovered benefits combined PCP $5 IN ; $40 OON Specialist continue reading
July 6, 2020
Premium $0 MOOP $7,550 PCP $0 copay Specialist $0 copay Inpatient Hospital $0 copay RX Deductible $0 RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $0 / $0-$3.70 / continue reading
July 6, 2020
Premium $0 MOOP $3,450 PCP $0 copay Specialist $0-$35 copay Inpatient Hospital $225 copay (days 1-5) RX Deductible $0 RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $0 / continue reading
July 6, 2020
Premium $0 MOOP $7,550 PCP $0 copay Specialist $0 copay Inpatient Hospital $0 copay RX Deductible $0 RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $0 / $0-$3.70 / continue reading
July 6, 2020
Premium $0 MOOP $7,550 PCP $0 copay Specialist $0 copay Inpatient Hospital $0 copay RX Deductible $0 RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $0 / $0-$3.70 / continue reading
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