Friday Health Plans Silver SV Plan (Cost)
Medicare Plan Details
2021 Plan
Monthly Premium
| (select county for price) |
by Friday Health Plans
Additional Coverage
Hearing
Vision
Dental
Overall Government Star Rating
No Ratingout 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
Plan Details
$56
$56
$0
$0
$6,700 In-network
No
Yes
Yes
Yes
Medical Benefits
Doctor Services
$35 copay per visit
$50 copay per visit
Tests, labs, & imaging
$0 copay
$0 copay
20% coinsurance
$0 copay
$75 copay per visit (always covered)
$40 copay per visit (always covered)
Hospital Services
$1,175 per stay
$300 copay per visit
Skilled nursing facility
$0 per day for days 1 through 20
$164.50 per day for days 21 through 100
$164.50 per day for days 21 through 100
Preventive services
$0 copay
Ambulance
$150 copay
Therapy services
$35 copay
$35 copay
Mental health services
$40 copay
$40 copay
$40 copay
$40 copay
Opioid treatment services
Covered
Other services
20% coinsurance per item
20% coinsurance per item
20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
20% coinsurance
20% coinsurance
Extra Benefits
Hearing
$35 copay
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
$35 copay
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
Health Plan Star Ratings
(government star ratings are out of 5 stars)
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