Regence | St. Luke's Health Partners Align No Rx (HMO)


Medicare Plan Details

2020 Plan
Monthly Premium
(select county for price)

 

by Regence BlueShield of Idaho
Additional Coverage
Hearing Vision Dental
Overall Government Star Rating
 4.0
out of 5 stars

State: Idaho

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

 

$0
$0
$0
$0
$5,200 In-network
No
Yes
Yes
Yes

Medical Benefits

Doctor Services

$0 copay
$30 per visit

Tests, labs, & imaging

$0 copay
$0 copay
20%
$0
$90 per visit (always covered)
$30 per visit (always covered)

Hospital Services

$310 per day for days 1 through 4
$0 per day for days 5 through 90
$30-275 per visit

Skilled nursing facility

$0 per day for days 1 through 20
$167 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$200

Therapy services

$30
$30

Mental health services

$30
$30
$0-30
$0-30

Opioid treatment services

Covered

Other services

20% per item
20% per item
$0 copay

Prescription Drug Benefits

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

Part B Drugs

20%
20%

Extra Benefits

Hearing

$30
Not covered
$0 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

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

Vision

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

Other benefits

Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4
 3
 4
 5
 4
No Rating

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