LIS Eligibility & Premium No LIS: $21.6025% Subsidy: $16.2050% Subsidy: $10.8075% Subsidy: $5.40100% Subsidy: $0 MOOP $5,900 PCP $0 copay Specialist $40 copay Inpatient Hospital $325 continue reading
2021
July 6, 2020
Premium $0 MOOP $5,500 applies to in-network Medicare-covered benefits ; $7,500 applies to in-network and out-ofnetwork Medicare-covered benefits combined PCP $5 copay IN ; $40 copay continue reading
July 6, 2020
Premium $29 MOOP $3,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $0 Inpatient Hospital $225 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery Center $0 continue reading
July 6, 2020
Premium $0 MOOP $6,900 applies to in-network Medicare-covered benefits PCP $0 Specialist $35 Inpatient Hospital $325 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery Center $0 continue reading
July 6, 2020
Premium $0 MOOP $5,500 applies to in-network Medicare-covered benefits ; $7,500 applies to in-network and out-ofnetwork Medicare-covered benefits combined PCP $5 copay IN ; $40 copay continue reading
July 6, 2020
Premium $16.80 MOOP $7,550 applies to in-network Medicare-covered benefits PCP $0 copay Specialist $0 copay Inpatient Hospital $225 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery continue reading
July 2, 2020
Premium $16.90 MOOP $6,700 applies to in-network Medicare-covered benefits PCP $0 copay Specialist $0 copay Inpatient Hospital $150 (days 1-5) ; $0 (days 6-90) Ambulatory Surgery continue reading
July 2, 2020
Premium $0 MOOP $5,500 applies to in-network Medicare-covered benefits PCP $0 copay Specialist $0 copay Inpatient Hospital $325 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery continue reading
July 2, 2020
Premium $29 MOOP $3,900 applies to in-network Medicare-covered benefits PCP $0 copay Specialist $0 copay Inpatient Hospital $250 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery continue reading
July 2, 2020
Premium $0 MOOP $6,900 applies to in-network Medicare-covered benefits PCP $0 copay Specialist $40 copay Inpatient Hospital $325 (days 1-6) ; $0 (days 7-90) Ambulatory Surgery continue reading
June 22, 2020
Premium $0 MOOP $4,900 PCP $0 copay Specialist $35 copay Inpatient Hospital $285 copay (days 1-6) RX Deductible $150 (T3-T5) RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $4 continue reading
June 22, 2020
LIS Eligibility & Premium No LIS: $22.7025% subsidy: $1750% subsidy: $11.3075% subsidy: $5.70100% subsidy: $0 MOOP $5,900 PCP $0 copay Specialist $45 copay Inpatient Hospital $295 copay continue reading
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TMG University
