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
Alexandria City
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$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 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 $4,900 PCP $5 copay Specialist $45 copay Inpatient Hospital $300 copay (days 1-5) RX Deductible $325 (T3-T5) RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $4 continue reading
July 6, 2020
Premium $0 MOOP $5,900 PCP $0 copay Specialist $40 copay Inpatient Hospital $325 copay (days 1-5) RX Deductible $325 (T3-T5) RX Preferred Cost Share T1/T2/T3/T4/T5/T6 $4 continue reading
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