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
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 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
July 6, 2020
LIS Eligibility & Premium No LIS: $24.3025% Subsidy: $18.2050% Subsidy: $12.1075% Subsidy: $6.10100% Subsidy: $0 MOOP $5,200 PCP $0 copay Specialist $40 copay Inpatient Hospital $300 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
July 6, 2020
Premium $0 MOOP $3,450 PCP $0 copay Specialist $0 - $35 copay Inpatient Hospital $325 copay (days 1-5) RX Deductible $0 RX Preferred Cost Share T1/T2/T3/T4/T5/T6 continue reading
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