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  1. NY
  2. CDPHP Medicare Advantage
  3. Plan

CDPHP Flex (PPO)

Medicare Plan Details (2023 Plan)

Monthly Premium

 

by CDPHP Medicare Advantage
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 5.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

Plan Details

$0
$0
$0
$0
$10,000 In and Out-of-network
$6,100 In-network
$10,000 Out-of-network
No
Yes
Yes
Yes
https://findadoc.cdphp.com/
https://www.cdphp.com/medicare

Medical Benefits

Doctor Services

In-network: $0 copay
Out-of-network: $40 copay per visit
In-network: $0-40 copay per visit
Out-of-network: 30% coinsurance per visit

Tests, labs, & imaging

In-network: $0-40 copay
Out-of-network: 30% coinsurance
In-network: $0-5 copay
Out-of-network: 30% coinsurance
In-network: $135 copay
Out-of-network: 30% coinsurance
In-network: $35 copay
Out-of-network: $40 copay
$90 copay per visit (always covered)
$60 copay per visit (always covered)

Hospital Services

In-network: $310 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: 30% per stay
In-network: $325 copay per visit
Out-of-network: 30% coinsurance per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$145 per day for days 21 through 100
Out-of-network: 30% per stay

Preventive services

In-network: $0 copay
Out-of-network: 30% coinsurance

Ambulance

In-network: $255 copay
Out-of-network: $255 copay

Therapy services

In-network: $40 copay
Out-of-network: $60 copay
In-network: $40 copay
Out-of-network: $60 copay

Mental health services

In-network: $40 copay
Out-of-network: $60 copay
In-network: $40 copay
Out-of-network: $60 copay
In-network: $40 copay
Out-of-network: $60 copay
In-network: $40 copay
Out-of-network: $60 copay

Opioid treatment services

Covered

Other services

In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
In-network: 20% coinsurance per item
Out-of-network: 30% coinsurance per item
In-network: 0-20% coinsurance per item
Out-of-network: 30% coinsurance per item

Prescription Drug Benefits

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

Part B Drugs

In-network: 20% coinsurance
Out-of-network: 30% coinsurance
In-network: $35 copay or 20% coinsurance
Out-of-network: 30% coinsurance

Extra Benefits

Hearing

In-network: $45 copay
Out-of-network: $0-45 copay
In-network: $0 copay
Out-of-network: $0-45 copay
In-network: $599-899 copay
Out-of-network: $599-899 copay

Preventive Dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Comprehensive dental

In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay

Vision

In-network: $20 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
In-network: $0 copay
Out-of-network: $0 copay
Not covered

Other benefits

Limited coverage
Limited coverage
Limited coverage
Not covered
Limited coverage
Limited coverage
Limited coverage

Health Plan Star Ratings

(government star ratings are out of 5 stars)
 5
 5
 4
 5
 4
No Rating (new plans)

When Can I Sign Up for Medicare?

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