Community Health Plan of WA MA Plan 2 (HMO)

Washington Medicare Advantage Plan (2024 Plan)


Monthly Premium

Your Cost
$38
by Community Health Plan of WA Medicare Advantage

Additional Coverage

HearingDental

Overall Government Star Rating

 3.5
out of 5 stars

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Plan Name
Community Health Plan of WA MA Plan 2 (HMO)
Insurance Carrier
Community Health Plan of WA Medicare Advantage
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
HMO

Community Health Plan of WA MA Plan 2 (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Washington and offered by the health insurance company Community Health Plan of WA Medicare Advantage. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$38
Annual Deductible
$0
Max Out-of-Pocket
$8,850
Primary doctor visit
$0 copay
Specialist visit
$50 copay per visit
ER visit
$100 copay per visit (always covered)
Ambulance
$350 copay

Community Health Plan of WA MA Plan 2 (HMO) has a monthly premium cost of $38 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $8,850 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 Community Health Plan of WA MA Plan 2 (HMO) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
No
Vision
Yes
Hearing

Community Health Plan of WA MA Plan 2 (HMO) 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. Community Health Plan of WA MA Plan 2 (HMO) includes coverage for hearing, dental.

Medicare Advantage health plans can offer even more additional benefits. Community Health Plan of WA MA Plan 2 (HMO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Limited coverage
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Not covered
Telehealth
Limited coverage

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, Community Health Plan of WA MA Plan 2 (HMO) received an overall government quality rating of 3.5 stars out of 5 stars.

Community Health Plan of WA MA Plan 2 (HMO) performed the same as Washington’s State average overall quality score of 3.5 stars.

This Plan’s 5-star Gov’t Quality Score
Washington State Average Score
Overall Government 5 Star Quality Rating
 3.5
 3.5
Summary rating of health plan quality
 3.5
 3.4
Staying healthy: screenings, tests, & vaccines
 4
 3.9
Managing chronic (long term) conditions
 3
 3.5
Member experience with health plan
 3
 3.1
Member complaints & changes in the health plan's performance
 5
 3.7
Health plan customer service
 4
 4.0
Summary rating of drug plan quality
 4
 3.6
Drug plan customer service
 3
 3.6
Member complaints & changes in the drug plan's performance
 5
 4.1
Member experience with the drug plan
 4
 3.2
Drug safety & accuracy of drug pricing
 3
 3.4

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Community Health Plan of WA MA Plan 2 (HMO) received 3.5 stars for its health plan quality score which is better than the Washington State average health plan quality score of 3.4 stars.

Community Health Plan of WA MA Plan 2 (HMO) received 4 stars for its drug plan quality score which is better than the Washington State average drug plan quality score of 3.6 stars.


Monthly Premium
$38
Health Portion of Premium
$0
Drug Portion of Premium
$38
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$8,850 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
No
Dental Coverage included
Yes
Doctor Lookup Link

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
$50 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
20% coinsurance
Lab services
$0 copay
Diagnostic radiology services (like MRI)
20% coinsurance
Outpatient x-rays
$15 copay
Emergency care
$100 copay per visit (always covered)
Urgent care
$40 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
$500 per day for days 1 through 4
$0 per day for days 5 through 90
Outpatient hospital coverage
$365 copay per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$200 per day for days 21 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$350 copay

Therapy services

Occupational therapy visit
$40 copay
Physical therapy & speech & language therapy visit
$45 copay

Mental health services

Outpatient group therapy with a psychiatrist
20% coinsurance
Outpatient individual therapy with a psychiatrist
20% coinsurance
Outpatient group therapy visit
$40 copay
Outpatient individual therapy visit
$40 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
20% coinsurance per item
Prosthetics (like braces, artificial limbs)
20% coinsurance per item
Diabetes supplies
$0 copay

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

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$10.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$0 copay

Brand-name drugs :
$0 copay

Generic$20.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug50%
Specialty Tier33%

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Hearing

Hearing exam
20% coinsurance
Fitting/evaluation
Not covered
Hearing aids - Inner ear
Not covered
Hearing aids - Outer ear
Not covered
Hearing aids - Over the ear
Not covered

Preventive Dental

Oral exam
$0 copay
Cleaning
$0 copay
Fluoride treatment
$0 copay
Dental x-rays
$0 copay

Comprehensive dental

Non-routine services
$0 copay
Diagnostic services
$0 copay
Restorative services
$0 copay
Endodontics
$0 copay
Periodontics
$0 copay
Extractions
$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services
$0 copay

Vision

Routine eye exam
Not covered
Contact lenses
Not covered
Eyeglasses (frames & lenses)
Not covered
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
Not covered

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