Zing Open Choice Diabetes & Heart IN (PPO C-SNP)
Indiana Chronic Condition Special Needs C-SNP Plan (2024 Plan)
Additional Coverage
HearingVisionDental
Overall Government Star Rating
No Rating (new plan)
Plan Name
Zing Open Choice Diabetes & Heart IN (PPO C-SNP)
Plan Type
Chronic Condition Special Needs Plan (C-SNP)
Zing Open Choice Diabetes & Heart IN (PPO C-SNP) is a Chronic Condition Special Needs Plan (C-SNP), which is available in Indiana and offered by the health insurance company Zing Health. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Primary doctor visit
$0 copay
Specialist visit
$20-35 copay per visit
ER visit
$100 copay per visit (always covered)
Zing Open Choice Diabetes & Heart IN (PPO C-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,350 In and Out-of-network
$6,350 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for Zing Open Choice Diabetes & Heart IN (PPO C-SNP) are defined below.
Yes
Part D Prescription Drug Coverage
Zing Open Choice Diabetes & Heart IN (PPO C-SNP) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Zing Open Choice Diabetes & Heart IN (PPO C-SNP) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Zing Open Choice Diabetes & Heart IN (PPO C-SNP) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
$6,350 In and Out-of-network
$6,350 In-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $20-35 copay per visit
Out-of-network: $20-35 copay per visit
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $0-25 copay
Out-of-network: $0-25 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $50-150 copay
Out-of-network: $50-150 copay
Outpatient x-rays
In-network: $0 copay
Out-of-network: $0 copay
Emergency care
$100 copay per visit (always covered)
Urgent care
$0-10 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
In-network: $350 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: $350 per day for days 1 through 6
$0 per day for days 7 through 90
Outpatient hospital coverage
In-network: $300 copay per visit
Out-of-network: $300 copay per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$203 per day for days 21 through 100
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $200 copay
Out-of-network: $200 copay
Therapy services
Occupational therapy visit
In-network: $20 copay
Out-of-network: $20 copay
Physical therapy & speech & language therapy visit
In-network: $20 copay
Out-of-network: $20 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $40 copay
Out-of-network: $40 copay
Outpatient individual therapy with a psychiatrist
In-network: $40 copay
Out-of-network: $40 copay
Outpatient group therapy visit
In-network: $40 copay
Out-of-network: $40 copay
Outpatient individual therapy visit
In-network: $40 copay
Out-of-network: $40 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Diabetes supplies
In-network: 0-20% coinsurance per item
Out-of-network: 0-20% coinsurance per item
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Gap coverage phase1 | Catastrophic coverage phase |
---|
Preferred Generic | $0.00 copay | $0.00 copay |
Generic drugs :
$0 copay Brand-name drugs :
$0 copay |
Generic | $8.00 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
Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: 0-20% coinsurance
Hearing
Hearing exam
In-network: $45 copay
Out-of-network: $45 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: 50% coinsurance
Hearing aids - Inner ear
In-network: $0 copay
Out-of-network: 50% coinsurance
Hearing aids - Outer ear
In-network: $0 copay
Out-of-network: 50% coinsurance
Hearing aids - Over the ear
In-network: $0 copay
Out-of-network: 50% coinsurance
Preventive Dental
Oral exam
Covered under office visit
Cleaning
Covered under office visit
Fluoride treatment
Covered under office visit
Dental x-rays
Covered under office visit
Comprehensive dental
Non-routine services
In-network: $0 copay
Out-of-network: 50% coinsurance
Diagnostic services
In-network: $0 copay
Out-of-network: 50% coinsurance
Restorative services
In-network: $0 copay
Out-of-network: 50% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 50% coinsurance
Extractions
In-network: $0 copay
Out-of-network: 50% coinsurance
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: $0 copay
Out-of-network: 50% coinsurance
Vision
Routine eye exam
In-network: $0 copay
Out-of-network: 50% coinsurance
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
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