Great Plains Medicare Advantage Gold (HMO I-SNP)
Medicare Plan Details (2023 Plan)
Monthly Premium
by Great Plains Medicare Advantage
Additional Coverage
Overall Government Star Rating
No Rating (new plans)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
Medical Benefits
Doctor Services
Tests, labs, & imaging
Hospital Services
$0 per day for days 6 through 90
Skilled nursing facility
$0 copay for days 1 through 20
$200 copay per day for days 21 through 100
Preventive services
Ambulance
Therapy services
Mental health services
Opioid treatment services
Other services
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $4.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | $10.00 copay | ||
| Preferred Brand | $45.00 copay | ||
| Non-Preferred Drug | $95.00 copay | ||
| Specialty Tier | 33% |
Part B Drugs
Extra Benefits
Hearing
Preventive Dental
Comprehensive dental
Vision
Other benefits
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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