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TTY users 711
Medicare65quote.com
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CareOne (HMO)
Medicare Plan Details (2022 Plan)
Monthly Premium
by CarePlus Health Plans, Inc.
Additional Coverage
HearingVisionDental
Overall Government Star Rating
5.0out of 5 stars
Ready to Enroll Online?
Plan Type
Medicare Advantage (Part C) with Prescription Drug (Part D)
Medicare Advantage combines Part A and Part B. This plan = Part A + Part B + Part D
Plan Details
$0
$0
$0
$0
$2,500 In-network
No
Yes
Yes
Yes
Medical Benefits
Doctor Services
$0 copay
$0 copay
Tests, labs, & imaging
$0-40 copay
$0 copay
$0-40 copay
$0-25 copay
$120 copay per visit (always covered)
$0 copay
Hospital Services
$0 copay per stay
$0-45 copay per visit
Skilled nursing facility
$0 per day for days 1 through 20
$50 per day for days 21 through 100
$50 per day for days 21 through 100
Preventive services
$0 copay
Ambulance
$0 copay
Therapy services
$0 copay
$0 copay
Mental health services
$0 copay
$0 copay
$0 copay
$0 copay
Opioid treatment services
Covered
Other services
$0 copay or 20% coinsurance per item
$0 copay
$0 copay
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase1 | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $5.00 copay | $5.00 copay |
Brand-name drugs :
|
| Generic | $10.00 copay | $10.00 copay | |
| Preferred Brand | $47.00 copay | ||
| Non-Preferred Drug | $100.00 copay | ||
| Specialty Tier | 33% | ||
| 1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. | |||
Part B Drugs
20% coinsurance
20% coinsurance
Extra Benefits
Hearing
$0 copay
$0 copay
$0 copay
Preventive Dental
$0 copay
$0 copay
$0 copay
$0 copay
Comprehensive dental
Not covered
Not covered
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Vision
$0 copay
$0 copay
$0 copay
Not covered
Not covered
Not covered
Other benefits
Limited coverage
Limited coverage
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
Health Plan Star Ratings
(government star ratings are out of 5 stars)
Prescription Drug Plan Star Ratings
(government star ratings are out of 5 stars)
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TTY 711
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