|
Florida Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan. Most Medicare Advantage plans cover prescription drugs, and many plans may offer other additional benefits Original Medicare doesn’t cover. Learn more about Florida Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price. Enrollment may be limited to certain times of the year.
Compare plans today.
Speak with a licensed insurance agent 1-800-557-6059 | TTY 711, 24/7 Basic Costs and Coverage CoverageDetailsMonthly plan premium $0.00 Vision coverage Dental coverage Hearing coverage Prescription drugs Medical deductible $600.00 Out-of-pocket maximum $6,750.00 Initial drug coverage limit $0.00 Catastrophic drug coverage limit $2,100.00 Primary care doctor visit In-Network: Doctor Office Visit: Copayment for Primary Care Office Visit $0 Specialty doctor visit In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $45 Prior Authorization Required for Doctor Specialty Visit Inpatient hospital care Out-of-Network: Acute Hospital Services: $400 per day for days 1 to 7 $0 per day for days 8 to 90 Urgent care Urgent Care: Copayment for Urgent Care $15 Worldwide Coverage: Copayment for Worldwide Urgent Coverage $130 Emergency room visit Emergency Care: Copayment for Emergency Care $130 Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours Worldwide Coverage: Copayment for Worldwide Emergency Coverage $130 Copayment for Worldwide Emergency Transportation $130 Ambulance transportation In-Network: Ground Ambulance: Copayment for Ground Ambulance Services $190 to $240 $240 Ambulance Emergency - Ground Ambulance$190 Ambulance Non-Emergency - Ground Ambulance Air Ambulance: Coinsurance for Air Ambulance Services 20% Prior Authorization Required for Air Ambulance Health Care Services and Medical Supplies Humana Full Access Giveback H7617-111 (PPO) covers a range of additional benefits. Learn more about Humana Full Access Giveback H7617-111 (PPO) benefits, some of which may not be covered by Original Medicare (Part A and Part B). CoverageDetailsChiropractic services In-Network: Chiropractic Services: Copayment for Medicare-covered Chiropractic Services $15 Prior Authorization Required for Chiropractic Services Diabetes supplies, training, nutrition therapy and monitoring Out-of-Network: Diabetic Supplies and Services: Copayment for Medicare Covered Diabetic Supplies $0 Coinsurance for Medicare Covered Diabetic Supplies 20% Copayment for Medicare Covered Diabetic Therapeutic Shoes or Inserts $5 Durable medical equipment (DME) In-Network: Durable Medical Equipment: Copayment for Medicare-covered Durable Medical Equipment $0 Coinsurance for Medicare-covered Durable Medical Equipment 15% Prior Authorization Required for Durable Medical Equipment $0 Continuous Glucose Monitor - DME Prov$0 Continuous Glucose Monitor - Pharmacy15% DME - DME Prov15% DME - Pharmacy$0 DME-Oxygen System - DME Prov Diagnostic tests, lab and radiology services, and X-rays Out-of-Network: Diagnostic Procedures/Tests Services: Copayment for Medicare Covered Diagnostic Procedures/Tests $0 to $150 Coinsurance for Medicare Covered Diagnostic Procedures/Tests 20% Copayment for Medicare Covered Lab Services $0 to $50 Copayment for Medicare Covered Diagnostic Radiological Services $0 to $335 Copayment for Medicare Covered Therapeutic Radiological Services $45 Coinsurance for Medicare Covered Therapeutic Radiological Services 20% Copayment for Medicare Covered Outpatient X-Ray Services $0 to $110 20% OP Diag Proc & Tests - OPH$0 OP Diag Proc & Tests - PCP$45 OP Diag Proc & Tests - SPC$15 OP Diag Proc & Tests - UCC$150 Sleep Study (Fac Based) - OPH$150 Sleep Study (Fac Based) - SPC$0 Sleep Study (Home Based) - Mbr's Home Home health care Out-of-Network: Home Health Services: Copayment for Medicare Covered Home Health $0 Mental health inpatient care Out-of-Network: Psychiatric Hospital Services: $400 per day for days 1 to 5 $0 per day for days 6 to 90 Mental health outpatient care Out-of-Network: Mental Health Services: Copayment for Medicare Covered Individual Sessions $30 Copayment for Medicare Covered Group Sessions $30 Outpatient services/surgery Out-of-Network: Outpatient Hospital Services: Copayment for Medicare Covered Outpatient Hospital Services $0 to $295 Copayment for Medicare Covered Ambulatory Surgical Center Services $0 to $175 $0 Diag Colonoscopy - OPH$35 Mental Health - OPH$295 Surgery Svcs - OPH$45 Wound Care - OPH Outpatient substance abuse care Out-of-Network: Outpatient Substance Abuse Services: Copayment for Medicare Covered Individual Sessions $30 to $35 Copayment for Medicare Covered Group Sessions $30 to $35 $35 OP Substance Abuse Care - OPH$30 OP Substance Abuse Care - SPC Podiatry services Out-of-Network: Podiatry Services: Copayment for Medicare Covered Podiatry Services $35 Skilled Nursing Facility (SNF) care Out-of-Network: Skilled Nursing Facility Services: $0 per day for days 1 to 20 $160 per day for days 21 to 100 Dental Benefits The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage. CoverageDetailsDental care $0 copayment for comprehensive oral evaluation or periodontal exam up to 1 every 3 years. $0 copayment for panoramic film or diagnostic x-rays up to 1 every 5 years. $0 copayment for bitewing x-rays, intraoral x-rays up to 1 set(s) per year. $0 copayment for emergency diagnostic exam up to 1 per year. $0 copayment for periodic oral exam, prophylaxis (cleaning) up to 2 per year. $0 copayment for periodontal maintenance up to 4 per year. $0 copayment for necessary anesthesia with covered service up to as needed with covered codes per year. $25 copayment per tooth for amalgam and/or composite filling up to 2 per year. $1,000 combined maximum benefit coverage amount per year for preventive and comprehensive benefits. Vision Benefits The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage CoverageDetailsVision care In-Network: Eye Exams: Copayment for Medicare Covered Benefits $0 to $45 Copayment for Routine Eye Exams $0 Maximum 1 Routine Eye Exams every year Prior Authorization Required for Eye Exams$0 Diab Eye Exam - All POTs$45 Vision Svcs (MC) - SPC Eyewear: Copayment for Medicare-Covered Benefits $0 Copayment for Contact Lenses $0 Maximum 1 Pair every year Copayment for Eyeglasses (lenses and frames) $0Maximum 1 Pair every year Maximum Plan Benefit of $100 every yearMembers must use Humana's Medicare Insight Network, a national network of providers, which includes standard or PLUS providers. The allowance for the standard network is $50 less than the PLUS network. Hearing Benefits The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage. CoverageDetailsHearing care Out-of-Network: Hearing Exams Services: Copayment for Medicare Covered Hearing Exams $45 Preventive Services and Health/Wellness Education Programs The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage. CoverageDetailsPreventive services and health/wellness education programs Out-of-Network: Medicare-covered Preventive Services: Copayment for Medicare Covered Medicare-covered Preventive Services $0 Prescription Drug Costs and Coverage The Humana Full Access Giveback H7617-111 (PPO) offers prescription drug coverage, with an annual drug deductible of $600.00 (excludes Tiers 1 and 2) Coverage & Cost Coverage Cost Annual drug deductible $600.00 (excludes Tiers 1 and 2) Tier 1 Standard retail $0.00 Preferred mail order $0.00 Standard mail order $10.00 Tier 2 Standard retail $5.00 Preferred mail order $5.00 Standard mail order $20.00 Annual drug deductible $600.00 (excludes Tiers 1 and 2) Tier 1 Standard retail N/A Preferred mail order N/A Standard mail order N/A Tier 2 Standard retail N/A Preferred mail order N/A Standard mail order N/A Annual drug deductible $600.00 (excludes Tiers 1 and 2) Tier 1 Standard retail $0.00 Preferred mail order $0.00 Standard mail order $30.00 Tier 2 Standard retail $15.00 Preferred mail order $0.00 Standard mail order $60.00 When reviewing Florida Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs. You may be able to find plans in your part of Florida that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans. Plan Documents Links to plan documentsFlorida Counties Served We offer plans from Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Healthspring, Wellcare, or Kaiser Permanente. (责任编辑：) |