CommuniCare Advantage CSNP (HMO C-SNP)

Medicare Plan Details (2023 Plan)


Monthly Premium

 

by Communicare Advantage
Additional Coverage
HearingVisionDental
Overall Government Star Rating
No Rating (new plans)
out of 5 stars

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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

 

$0
$0
$0
$0
$8,300 In-network
No
Yes
Yes
Yes

Doctor Services

$0 copay
$10-50 copay per visit

Tests, labs, & imaging

20% coinsurance
$3-20 copay
20% coinsurance
20% coinsurance
$90 copay per visit (always covered)
$40 copay per visit (always covered)

Hospital Services

$375 per day for days 1 through 5
$0 per day for days 6 through 90
20% coinsurance per visit

Skilled nursing facility

$0 per day for days 1 through 20
$194.50 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

20% coinsurance

Therapy services

$40 copay
$40 copay

Mental health services

$40 copay
$40 copay
$35 copay
$35 copay

Opioid treatment services

Covered

Other services

20% coinsurance per item
20% coinsurance per item
$0 copay

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

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$6.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$4.15 copay or 5% (whichever costs more)

Brand-name drugs :
$10.35 copay or 5% (whichever costs more)

Generic$17.00 copay
Preferred Brand$45.00 copay
Non-Preferred Drug$92.00 copay
Specialty Tier25%

Part B Drugs

20% coinsurance
20% coinsurance

Hearing

20% coinsurance
$0 copay
$0 copay

Preventive Dental

$0 copay
$0 copay
Not covered
$0 copay

Comprehensive dental

Not covered
$0 copay
$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

Not covered
Not covered
Not covered
Not covered
Limited coverage
Not covered
Limited coverage
No Rating (new plans)
No Rating (new plans)
 1
No Rating (new plans)
 5
 5
 3.5
 4
 5
No Rating (new plans)
 3

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