No obligation to enroll. Mon-Fri: 8am-9pm, Sat: 8am-8pm ET
Advertisement from our partner
TTY users 711
Medicare65quote.com
Ready to Enroll Online?
Community Health Plan of WA MA Plan 2 (HMO)
Medicare Plan Details (2022 Plan)
Monthly Premium
by Community Health Plan of WA Medicare Advantage
Additional Coverage
HearingVisionDental
Overall Government Star Rating
3.5out of 5 stars
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
$0 copay
$40 copay per visit
Tests, labs, & imaging
20% coinsurance
$0 copay
20% coinsurance
$15 copay
$90 copay per visit (always covered)
$10 copay per visit (always covered)
Hospital Services
$450 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 5 through 90
$275 copay per visit
Skilled nursing facility
$0 per day for days 1 through 20
$160 per day for days 21 through 100
$160 per day for days 21 through 100
Preventive services
$0 copay
Ambulance
$325 copay
Therapy services
$40 copay
$40 copay
Mental health services
20% coinsurance
20% coinsurance
$30 copay
$30 copay
Opioid treatment services
Covered
Other services
20% coinsurance per item
20% coinsurance per item
$0 copay
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 | $5.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | $15.00 copay | ||
| Preferred Brand | $47.00 copay | ||
| Non-Preferred Drug | 50% | ||
| Specialty Tier | 33% |
Part B Drugs
20% coinsurance
20% coinsurance
Extra Benefits
Hearing
20% coinsurance
Not covered
Not covered
Not covered
Not covered
Preventive Dental
$0 copay
$0 copay
$0 copay
$0 copay
Comprehensive dental
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Vision
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
Other benefits
Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Not covered
Limited coverage
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)
When Can I Sign Up for Medicare?
Enter your birthday month and year to learn when you can sign up for different Medicare plan options.
Advertisement
Medicare Health Plans
Get Advice & Sign Up Help
TTY 711
Speak with a Licensed Insurance Agent
No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! Plan availability depends on your location. Licensed agents may not be able to provide assistance for all plans shown on this site.