欧胡岛计划2024年完工

计划起价为每月0美元.

HMSA can help you live your best life.

  • $0 dental cleanings, exams, X-rays, fillings, and more with no dollar limits or waiting period.
  • $300 annually toward eyeglasses and contact lenses. 改进的
  • Up to $95 allowance every quarter for over-the-counter health and wellness products. NEW
  • $0 copayments for primary care provider visits.
  • Care you need from providers you choose.
  • 友好的本地客户服务.
  • Convenient telehealth, including HMSA的在线护理®, at no cost.
  • 好处 for travel, fitness, prescription drugs, and more that go beyond Original Medicare.

澳门赌场大真钱攻略.

 wcagcolheaderHMSA Akamai Advantage Complete (PPO)HMSA Akamai Advantage Complete Plus (PPO)

每月的保费
(你每月支付的金额.)
You must continue to pay your Medicare Part B premium.

Low Income Subsidy can help pay for prescription drugs and monthly premiums. 了解更多.

$0$120
网络内自付最大值
(The most you pay each year for Medicare-covered services from in-network providers.)
$6,700$3,850
2024星级满分5星

4分(满分5星)H3832 [PDF]).

澳门赌场赌大真钱玩法目录
医疗福利*
 你支付你支付
年度扣除$0$0
住院治疗*

第1至第6天:
370美元/天

第7至60天:
50美元/天

第61至90天:
0美元/天

第1至5天:
350美元/天

第6至90天:
0美元/天

额外的一天:
0美元/天

熟练护理机构*

第1至20天:
0美元/天

第21至60天:
200美元/天

第61至100天:
0美元/天

第1至20天:
20美元/天

第21至40天:
190美元/天

第41至100天:
0美元/天

Outpatient hospital facility and ambulatory surgical center services*20%20%
初级保健提供者办公室访问$0$0
Specialty care provider office visit$50$30
年度健康访视$0$0
救护车服务
包括地面和空中.
$250$225
急救护理$100$100
紧急护理$50$30
Worldwide coverage for emergency and urgent care services 10%10%
Diagnostic tests and procedures, lab services, and outpatient X-rays*20%20%
医疗保险B部分药物*20%20%
医疗保险B部分胰岛素药物*$35$35
医疗设备和用品*20%20%
补充牙科福利
预防性牙科服务, including two oral exams every year, 每年清洗两次, 每年做一次x光检查, and two fluoride treatments every year$0$0
综合牙科服务, including four extractions every year and two fillings every year $0$0
综合牙科服务, including one root canal every year and one crown following a root canal on the same tooth every year 不包括$0
牙科澳门赌场赌大真钱玩法目录 牙科医生目录[PDF]
补充视力益处
 你支付你支付
常规眼科检查每日历年10/1次考试每日历年$0/1考试
澳门赌场赌大真钱玩法 lenses and eyeglasses (frames and lenses)$0
Plan pays up to $300 every calendar year
$0
Plan pays up to $300 every calendar year
其他补充福利

Over-the-Counter (OTC) Health Products

OTC health and wellness products available at select retail stores or through mail order delivery online at HMSAExtra 好处.com 或者通过呼叫 1-800-790-6019.

欲了解更多信息,请访问 e-linkland.com/ Extra好处

$0

该计划每季度支付65美元

$0

该计划每季度支付95美元

Over-the-Counter (OTC) Health Products Catalog

Over-the-Counter (OTC) Health Products Catalog [PDF]

健身-银牌&Fit Healthy Aging and Exercise Program
A membership to a participating fitness center, 每年一个家庭健身包, 健康老年辅导 sessions and more.

健身中心会员资格
$0/month for standard fitness center,
$30- $200/month for premium fitness center

家庭健身套件
$0
1 家庭健身套件 per calendar year

健康老年辅导
$0

数字健身视频
$0

健身中心会员资格
$0/month for standard fitness center,
$30- $200/month for premium fitness center

家庭健身套件
$0
1 家庭健身套件 per calendar year

健康老年辅导
$0

数字健身视频
$0

远程医疗服务
包括 HMSA的在线护理.
$0$0
健康教育$0
了解更多
$0
了解更多
健康指导$0
了解更多
$0
了解更多
药物的好处
 你支付你支付

年度扣除

Low Income Subsidy can help pay for prescription drugs and monthly premiums. 了解更多.

$380
Does not apply to tier 1 drugs, insulin and most D部分疫苗
$0
初始覆盖阶段
Until total drug costs reach $5,030
30-day supply from retail pharmacies
一级-首选通用
$4.50$4
第2层-通用
$12$11
三级-首选品牌
$47$45
第3级-首选品牌胰岛素
$35$35
第4层-非首选药物
$100$95
5级-专精
27%33%
第5级-专业胰岛素
$35$35
100-day supply from mail-order pharmacy
一级-首选通用
$4.50$4
第2层-通用
$12$11
三级-首选品牌
$94$90
三级-首选品牌胰岛素
$70$70
第4层-非首选药物
$200$190
5级-专精
27%33%
第5级-专业胰岛素
$105$105
覆盖缺口阶段
Until your yearly out-of-pocket drug costs 达到8000美元
25% of the cost of brand or generic drugs
Additional gap coverage for Tier 1 drugs
零售药房30天的供应量不包括$4
100-day supply from mail-order pharmacy不包括$4
灾难覆盖阶段
After your yearly out-of-pocket drug costs
达到8000美元
$0 for generic drugs (including brand drugs treated as generic) and all other drugs
D部分疫苗$0 for most D部分疫苗 on all drug tiers.
药店找药店
Prescription Drugs List (Formulary)
See if your prescription drugs are covered and search for lower-cost alternatives. 药物检索工具.
资源及计划资料
利益摘要福利摘要[PDF] 福利摘要[PDF]
周年变更通知书周年变更通知书[PDF]周年变更通知书[PDF]
承保证明
成员资源了解更多了解更多

HMSA免责声明

  • This plan information is effective January 1, 2024.
  • Medicare beneficiaries may also enroll in HMSA Akamai Advantage through the CMS Medicare Online Enrollment Center at www.医疗保险.gov.
  • Every year, Medicare evaluates plans based on a 5-star rating system.
  • Benefit amounts listed are based on using HMSA participating providers.
  • HMSA Akamai Advantage® is a PPO plan with a Medicare contract. Enrollment in HMSA Akamai Advantage depends on contract renewal.

* For some services, your doctor or other network provider may request prior authorization. Please contact us for more information.