Friday Health Plans Gold SV Plan (Cost)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Friday Health Plans of Colorado
Additional Coverage
Vision Dental
Overall Government Star Rating
No Rating
out of 5 stars

State: Colorado

Select your county to view the price for this plan

 


Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$55
$55
$0
$0
$6,700 In-network
No
No
Yes
Yes

Medical Benefits

Doctor Services

$25 per visit
$40 per visit

Tests, labs, & imaging

$0 copay
$0 copay
20%
$0 copay
$75 per visit (always covered)
$35 per visit (always covered)

Hospital Services

$850 per stay
$300 per visit

Skilled nursing facility

$0 per day for days 1 through 20
$164.50 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$150

Therapy services

$25
$25

Mental health services

$30
$30
$30
$30

Opioid treatment services

Covered

Other services

20% per item
20% per item
20% per item

Prescription Drug Benefits

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

Part B Drugs

Not Applicable
Not Applicable

Extra Benefits

Hearing

$35
Not covered
Not covered
Not covered
Not covered

Preventive Dental

Covered under office visit
Covered under office visit
Not covered
Covered under office visit

Comprehensive dental

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered

Vision

$30
Not covered
$0 copay
Not covered
Not covered
Not covered

Other benefits

Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
Not covered
No Rating
 2
No Rating
No Rating
No Rating
No Rating

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