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California MedicareAdvantage Plans

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Medicare Advantage Plans in Downey, California

Below are Medicare Advantage plans available to residents of Downey, California. 21 carriers offer 57 plans throughout the city of Downey. Residents may chose plans from carriers such as Humana Health Plan of California Inc., Blue Shield of California and Aetna Medicare. This data has been made available by the Centers for Medicare & Medicaid Services (CMS) and is for informational purposes only. Some data may be inaccurate or incomplete. Please note that plans can vary by city, county, and state and all plans listed may not be available in all areas. To speak to an advisor and find the Medicare Advantage plan in Downey that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the city of Downey

Carrier Plan Title Plan Type
Humana Health Plan of California Inc. Humana Gold Plus H0108-011 (HMO) (H0108-011) HMO

    Premium and Other Important Information

    • Package: 1 - MyOption Enhanced Dental HMO:
    • $36 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
    • $3 400 out-of-pocket limit for Medicare-covered services.
    • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

    Doctor Office Visits

    • Authorization rules may apply.
    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
    • $25 copay for each in-area network urgent care Medicare-covered visit
    • $10 copay for each specialist visit for Medicare-covered benefits.
    Humana Health Plan of California Inc. Humana Gold Plus H0108-012 (HMO-POS) (H0108-012) HMO with POS Option

      Premium and Other Important Information

      • Package: 1 - MyOption Enhanced Dental HMO:
      • $36 monthly premium in addition to your $39 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
      • $5 000 out-of-pocket limit for Medicare-covered services.
      • $39 monthly plan premium in addition to your monthly Medicare Part B premium.
      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

      Doctor Office Visits

      • Authorization rules may apply.
      • $0 copay for each primary care doctor visit for Medicare-covered benefits.
      • $25 copay for each in-area network urgent care Medicare-covered visit
      • $10 copay for each specialist visit for Medicare-covered benefits.
      Blue Shield of California Blue Shield 65 Plus (HMO) (H0504-015) HMO

        Premium and Other Important Information

        • $3 000 out-of-pocket limit for Medicare-covered services.
        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

        Doctor Office Visits

        • Authorization rules may apply.
        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
        • $10 copay for each in-area network urgent care Medicare-covered visit
        • $5 copay for each specialist visit for Medicare-covered benefits.
        Blue Shield of California Blue Shield 65 Plus Choice Plan (HMO) (H0504-021) HMO

          Premium and Other Important Information

          • $2 000 out-of-pocket limit for Medicare-covered services.
          • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

          Doctor Office Visits

          • Authorization rules may apply.
          • $0 copay for each primary care doctor visit for Medicare-covered benefits.
          • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
          • $0 copay for each specialist doctor visit for Medicare-covered benefits.
          Aetna Medicare Aetna Medicare Select Plan (HMO) (H0523-002) HMO

            Premium and Other Important Information

            • Package: 1 - Preventive Dental:
            • Package: 2 - Advantage Dental:
            • $3 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
            • $9 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
            • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

            Doctor Office Visits

            • $5 copay for each primary care doctor visit for Medicare-covered benefits.
            • $15 copay for each in-area network urgent care Medicare-covered visit
            • $10 copay for each specialist visit for Medicare-covered benefits.
            Kaiser Permanente Senior Advantage Kaiser Permanente Senior Advantage B Only South (HMO) (H0524-002) HMO

              Premium and Other Important Information

              • Package: 1 - Advantage Plus:
              • $20 monthly premium in addition to your $391 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Wear Hearing A
              • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
              • $391 monthly plan premium in addition to your monthly Medicare Part B premium.
              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

              Doctor Office Visits

              • Authorization rules may apply.
              • $5 copay for each primary care doctor visit for Medicare-covered benefits.
              • $5 copay for each in-area network urgent care Medicare-covered visit
              • $5 copay for each specialist visit for Medicare-covered benefits.
              Kaiser Permanente Senior Advantage Kaiser Permanente Senior Advantage LA Orange Co. (HMO) (H0524-003) HMO

                Premium and Other Important Information

                • Package: 1 - Advantage Plus:
                • $20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Wear Hearing Aid
                • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                Doctor Office Visits

                • Authorization rules may apply.
                • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                • $5 copay for each in-area network urgent care Medicare-covered visit
                • $5 copay for each specialist visit for Medicare-covered benefits.
                Kaiser Permanente Senior Advantage Senior Advantage Medicare Medi-Cal Plan South (HMO SNP) (H0524-029) HMO

                  Premium and Other Important Information

                  • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                  • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                  • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.*
                  • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                  Doctor Office Visits

                  • Authorization rules may apply.
                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                  • $0 copay for each in-area network urgent care Medicare-covered visit*
                  • $0 copay for each specialist visit for Medicare-covered benefits.*
                  AltaMed Senior BuenaCare AltaMed Senior BuenaCare (PACE) (H0542-001) National PACE
                    AltaMed Senior BuenaCare AltaMed Senior BuenaCare (PACE) (H0542-002) National PACE
                      UnitedHealthcare AARP MedicareComplete SecureHorizons (HMO) (H0543-001) HMO

                        Premium and Other Important Information

                        • Package: 1 - Deluxe Rider:
                        • Package: 2 - High Option Dental Rider:
                        • Package: 3 - Optional Dental Rider:
                        • $38 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Wear Hearing Aid
                        • $26 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                        • $6 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                        • $6 700 out-of-pocket limit for Medicare-covered services.
                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                        Doctor Office Visits

                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                        • $30 copay for each in-area network urgent care Medicare-covered visit
                        • $0 copay for each specialist visit for Medicare-covered benefits.
                        UnitedHealthcare UnitedHealthcare Dual Complete (HMO SNP) (H0543-078) HMO

                          Premium and Other Important Information

                          • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                          • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                          • $6 700 out-of-pocket limit for Medicare-covered services.*
                          • $23.2 monthly plan premium in addition to your monthly Medicare Part B premium.*

                          Doctor Office Visits

                          • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                          • $0 or $30 copay for each in-area network urgent care Medicare-covered visit*
                          • $0 copay for each specialist visit for Medicare-covered benefits.*
                          UnitedHealthcare AARP MedicareComplete SecureHorizons Essential (HMO) (H0543-121) HMO

                            Premium and Other Important Information

                            • Package: 1 - High Option Dental Rider:
                            • Package: 2 - Optional Dental Rider:
                            • $26 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                            • $6 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                            • $6 700 out-of-pocket limit for Medicare-covered services.
                            • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                            Doctor Office Visits

                            • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                            • $30 copay for each in-area network urgent care Medicare-covered visit
                            • $10 copay for each specialist visit for Medicare-covered benefits.
                            CareMore Health Plan CareMore Value Plus (HMO) (H0544-002) HMO

                              Premium and Other Important Information

                              • Package: 1 - Optional Dental:
                              • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                              • $3 400 out-of-pocket limit for Medicare-covered services.
                              • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                              Doctor Office Visits

                              • Authorization rules may apply.
                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                              • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                              • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                              CareMore Health Plan CareMore Connect (HMO SNP) (H0544-003) HMO

                                Premium and Other Important Information

                                • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                • $3 400 out-of-pocket limit for Medicare-covered services.*
                                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                Doctor Office Visits

                                • Authorization rules may apply.
                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                CareMore Health Plan CareMore Reliance (HMO SNP) (H0544-004) HMO

                                  Premium and Other Important Information

                                  • Package: 1 - Optional Dental:
                                  • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                  • $3 400 out-of-pocket limit for Medicare-covered services.
                                  • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                  Doctor Office Visits

                                  • Authorization rules may apply.
                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                  • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                  • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                  CareMore Health Plan CareMore Touch (HMO SNP) (H0544-005) HMO

                                    Premium and Other Important Information

                                    • Package: 1 - Optional Dental:
                                    • $15.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                    • $3 400 out-of-pocket limit for Medicare-covered services.
                                    • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                    Doctor Office Visits

                                    • Authorization rules may apply.
                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                    • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                    • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                    CareMore Health Plan StartSmart with CareMore (HMO) (H0544-007) HMO

                                      Premium and Other Important Information

                                      • CareMore Health Plan will reduce your monthly Medicare Part B premium by up to $ 75.00.
                                      • Package: 1 - Optional Dental:
                                      • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                      • $3 400 out-of-pocket limit for Medicare-covered services.
                                      • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                      Doctor Office Visits

                                      • Authorization rules may apply.
                                      • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                      • $15 copay for each in-area network urgent care Medicare-covered visit
                                      • $0 to $20 copay for each specialist visit for Medicare-covered benefits.
                                      CareMore Health Plan CareMore Heart (HMO SNP) (H0544-013) HMO

                                        Premium and Other Important Information

                                        • Package: 1 - Optional Dental:
                                        • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                        • $3 400 out-of-pocket limit for Medicare-covered services.
                                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                        Doctor Office Visits

                                        • Authorization rules may apply.
                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                        • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                        • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                        CareMore Health Plan CareMore Breathe (HMO SNP) (H0544-014) HMO

                                          Premium and Other Important Information

                                          • Package: 1 - Optional Dental:
                                          • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                          • $3 400 out-of-pocket limit for Medicare-covered services.
                                          • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                          Doctor Office Visits

                                          • Authorization rules may apply.
                                          • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                          • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                          • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                          CareMore Health Plan CareMore ESRD (HMO SNP) (H0544-015) HMO

                                            Premium and Other Important Information

                                            • Package: 1 - Optional Dental:
                                            • $11.20 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                            • $6 700 out-of-pocket limit for Medicare-covered services.
                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                            Doctor Office Visits

                                            • Authorization rules may apply.
                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                            • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                            • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                            Inter Valley Health Plan Inter Valley Health Plan Service To Seniors (HMO) (H0545-001) HMO

                                              Premium and Other Important Information

                                              • $3 400 out-of-pocket limit for Medicare-covered services.
                                              • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                              Doctor Office Visits

                                              • Authorization rules may apply.
                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                              • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                              • $0 to $10 copay for each specialist visit for Medicare-covered benefits.
                                              Inter Valley Health Plan Inter Valley Health Plan Total Fit (HMO) (H0545-011) HMO

                                                Premium and Other Important Information

                                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                Doctor Office Visits

                                                • Authorization rules may apply.
                                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                • $0 to $10 copay for each specialist visit for Medicare-covered benefits.
                                                Health Net of California Health Net Seniority Plus Green (HMO) (H0562-044) HMO

                                                  Premium and Other Important Information

                                                  • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                                                  • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                                                  Doctor Office Visits

                                                  • Authorization rules may apply.
                                                  • $7 copay for each primary care doctor visit for Medicare-covered benefits.
                                                  • $10 copay for each in-area network urgent care Medicare-covered visit
                                                  • $10 copay for each specialist visit for Medicare-covered benefits.
                                                  Health Net of California Health Net Seniority Plus Amber I (HMO SNP) (H0562-055) HMO

                                                    Premium and Other Important Information

                                                    • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                    • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                    • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.*
                                                    • $25.8 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                    Doctor Office Visits

                                                    • Authorization rules may apply.
                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                    • $0 copay for each in-area network urgent care Medicare-covered visit*
                                                    • $0 copay for each specialist visit for Medicare-covered benefits.*
                                                    Health Net of California Health Net Seniority Plus Amber II (HMO SNP) (H0562-070) HMO

                                                      Premium and Other Important Information

                                                      • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                      • In 2012 the annual Part B deductible amount is $0 or $140 .* Contact the plan for services that apply.
                                                      • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                      • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.*
                                                      • $30.9 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                      Doctor Office Visits

                                                      • Authorization rules may apply.
                                                      • 0% or 0% to 20% of the cost for each primary care doctor visit for Medicare-covered benefits.*
                                                      • 0% or 0% to 20% of the cost for each in-area network urgent care Medicare-covered visit*
                                                      • 0% or 0% to 20% of the cost for each specialist visit for Medicare-covered benefits.*
                                                      Health Net of California Health Net Healthy Heart Plan 1 (HMO) (H0562-082) HMO

                                                        Premium and Other Important Information

                                                        • Package: 1 - HMO Buy-Up 3: DHMO+Eyewear+Chiro/Acupuncture:
                                                        • Package: 2 - HMO Buy-Up 5: DPPO+Eyewear+Chiro/Acupuncture:
                                                        • $17 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh
                                                        • $27 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh
                                                        • $3 400 out-of-pocket limit. All plan services included.
                                                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                        Doctor Office Visits

                                                        • Authorization rules may apply.
                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                        • $10 copay for each in-area network urgent care Medicare-covered visit
                                                        • $0 copay for each specialist visit for Medicare-covered benefits.
                                                        Health Net of California Health Net Seniority Plus Ruby Plan 1 (HMO) (H0562-083) HMO

                                                          Premium and Other Important Information

                                                          • Package: 1 - DHMO+Eyewear+Chiro/Acupuncture+Health Club/Fitness:
                                                          • Package: 2 - DPPO+Eyewear+Chiro/Acupuncture+Health Club/Fitness:
                                                          • $19 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Supplemental Education/Wellness Prog
                                                          • $29 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Supplemental Education/Wellness Prog
                                                          • $3 400 out-of-pocket limit. All plan services included.
                                                          • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                          Doctor Office Visits

                                                          • Authorization rules may apply.
                                                          • $8 copay for each primary care doctor visit for Medicare-covered benefits.
                                                          • $10 copay for each in-area network urgent care Medicare-covered visit
                                                          • $10 copay for each specialist visit for Medicare-covered benefits.
                                                          Health Net of California Salud con Health Net Medicare Advantage (HMO) (H0562-085) HMO

                                                            Premium and Other Important Information

                                                            • $3 400 out-of-pocket limit for Medicare-covered services and select Non-Medicare Supplemental Services. Contact plan for details regarding Non-Medicare Supplemental Services covered under this limit.
                                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                            Doctor Office Visits

                                                            • Authorization rules may apply.
                                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                            • $10 copay for each in-area network urgent care Medicare-covered visit
                                                            • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                            Health Net of California Health Net Healthy Heart Plan 2 (HMO) (H0562-086) HMO

                                                              Premium and Other Important Information

                                                              • Package: 1 - DHMO+Eyewear+Chiro/Acupuncture+Health Club/Fitness:
                                                              • Package: 2 - DPPO+Eyewear+Chiro/Acupuncture+Health Club/Fitness:
                                                              • $19 monthly premium in addition to your $20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Supplemental Education/Wellness Pro
                                                              • $29 monthly premium in addition to your $20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Supplemental Education/Wellness Pro
                                                              • $3 400 out-of-pocket limit. All plan services included.
                                                              • $20 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                              Doctor Office Visits

                                                              • Authorization rules may apply.
                                                              • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                              • $25 copay for each in-area network urgent care Medicare-covered visit
                                                              • $25 copay for each specialist visit for Medicare-covered benefits.
                                                              Anthem Blue Cross Blue Cross Senior Secure Plan I (HMO) (H0564-006) HMO

                                                                Premium and Other Important Information

                                                                • Package: 1 - Preventive Dental Package:
                                                                • Package: 2 - Comprehensive Dental and Vision Package:
                                                                • Package: 3 - Combination Package:
                                                                • $12 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                • $32 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                                                                • $45 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh
                                                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                Doctor Office Visits

                                                                • Authorization rules may apply.
                                                                • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                • $30 copay for each in-area network urgent care Medicare-covered visit
                                                                • $30 copay for each specialist visit for Medicare-covered benefits.
                                                                Brand New Day Brand New Day (HMO SNP) (H0838-020) HMO

                                                                  Premium and Other Important Information

                                                                  • $6 700 out-of-pocket limit. All plan services included.
                                                                  • $30.9 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                  Doctor Office Visits

                                                                  • Authorization rules may apply.
                                                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                  • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                  • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                  Brand New Day Brand New Day (HMO) (H0838-022) HMO

                                                                    Premium and Other Important Information

                                                                    • $3 400 out-of-pocket limit. All plan services included.
                                                                    • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                    Doctor Office Visits

                                                                    • Authorization rules may apply.
                                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                    • $5 copay for each in-area network urgent care Medicare-covered visit
                                                                    • $7.50 copay for each specialist visit for Medicare-covered benefits.
                                                                    Brand New Day Brand New Day HMO Extra Care (HMO) (H0838-023) HMO

                                                                      Premium and Other Important Information

                                                                      • $6 700 out-of-pocket limit. All plan services included.
                                                                      • $30.9 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                      Doctor Office Visits

                                                                      • Authorization rules may apply.
                                                                      • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                      • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                      • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                      Golden State Medicare Health Plan Golden (HMO) Golden State Medicare Health Plan Golden (HMO) (H2241-001) HMO

                                                                        Premium and Other Important Information

                                                                        • $5 000 out-of-pocket limit for Medicare-covered services.
                                                                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                        Doctor Office Visits

                                                                        • Authorization rules may apply.
                                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                        • $0 copay for each in-area network urgent care Medicare-covered visit
                                                                        • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                        L.A. Care Health Plan Medicare Advantage L.A. Care Health Plan Medicare Advantage (HMO SNP) (H2643-001) HMO

                                                                          Premium and Other Important Information

                                                                          • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                          • $0 annual deductible.*
                                                                          • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                          • $6 700 out-of-pocket limit. All plan services included. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility. Contact plan for details regarding cost sharing
                                                                          • $0 monthly plan premium*

                                                                          Doctor Office Visits

                                                                          • Authorization rules may apply.
                                                                          • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                          • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                          • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                          Citizens Choice Healthplan Citizens Choice Healthplan (HMO) (H3815-001) HMO

                                                                            Premium and Other Important Information

                                                                            • $3 400 out-of-pocket limit. All plan services included.
                                                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                            Doctor Office Visits

                                                                            • Authorization rules may apply.
                                                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                            • $0 copay for each in-area network urgent care Medicare-covered visit
                                                                            • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                            Easy Choice Health Plan Easy Choice Freedom Plan (HMO SNP) (H5087-001) HMO

                                                                              Premium and Other Important Information

                                                                              • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                              • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                              • $6 700 out-of-pocket limit for Medicare-covered services.*
                                                                              • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                                              Doctor Office Visits

                                                                              • Authorization rules may apply.
                                                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                              • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                              • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                              Easy Choice Health Plan Easy Choice Best Plan (HMO) (H5087-005) HMO

                                                                                Premium and Other Important Information

                                                                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                Doctor Office Visits

                                                                                • Authorization rules may apply.
                                                                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                                • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                                SCAN Health Plan SCAN Classic (HMO) (H5425-006) HMO

                                                                                  Premium and Other Important Information

                                                                                  • Package: 1 - Dental Buy-Up #1:
                                                                                  • Package: 2 - Dental Buy-Up #2:
                                                                                  • $8 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                  • $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                  • $5 000 out-of-pocket limit for Medicare-covered services.
                                                                                  • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                  Doctor Office Visits

                                                                                  • Authorization rules may apply.
                                                                                  • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                  • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                                  • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                                  SCAN Health Plan SCAN Connections (HMO SNP) (H5425-010) HMO

                                                                                    Premium and Other Important Information

                                                                                    • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                    • $0 annual deductible.*
                                                                                    • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                    • $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                                                                    • $0 monthly plan premium*

                                                                                    Doctor Office Visits

                                                                                    • Authorization rules may apply.
                                                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                    • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                                    • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                    SCAN Health Plan My Choice (HMO-POS) (H5425-025) HMO with POS Option

                                                                                      Premium and Other Important Information

                                                                                      • Package: 1 - Dental Buy-Up #1:
                                                                                      • Package: 2 - Dental Buy-Up #2:
                                                                                      • $8 monthly premium in addition to your $40 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                      • $15 monthly premium in addition to your $40 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                      • $3 000 out-of-pocket limit for Medicare-covered services.
                                                                                      • $40 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                      • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                      Doctor Office Visits

                                                                                      • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                      • $25 copay for each in-area network urgent care Medicare-covered visit
                                                                                      • $20 copay for each specialist visit for Medicare-covered benefits.
                                                                                      SCAN Health Plan Heart First (HMO SNP) (H5425-028) HMO

                                                                                        Premium and Other Important Information

                                                                                        • Package: 1 - Dental Buy-Up #1:
                                                                                        • Package: 2 - Dental Buy-Up #2:
                                                                                        • $8 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                        • $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                        • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                        Doctor Office Visits

                                                                                        • Authorization rules may apply.
                                                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                        • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                                        • $0 copay for each specialist visit for Medicare-covered benefits.
                                                                                        SCAN Health Plan SCAN Connections at Home (HMO SNP) (H5425-029) HMO

                                                                                          Premium and Other Important Information

                                                                                          • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                          • $0 annual deductible.*
                                                                                          • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                          • $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                                                                          • $0 monthly plan premium*

                                                                                          Doctor Office Visits

                                                                                          • Authorization rules may apply.
                                                                                          • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                          • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                                          • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                          Central Health Medicare Plan Central Health Medicare Plan (HMO) (H5649-001) HMO

                                                                                            Premium and Other Important Information

                                                                                            • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                            Doctor Office Visits

                                                                                            • Authorization rules may apply.
                                                                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                            • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                                            • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                                            Central Health Medicare Plan Central Health Medi-Medi Plan (HMO SNP) (H5649-002) HMO

                                                                                              Premium and Other Important Information

                                                                                              • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                              • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                              • In this plan you will have no cost sharing responsibility for Medicare-covered services.
                                                                                              • $30.9 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                                                              Doctor Office Visits

                                                                                              • Authorization rules may apply.
                                                                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                              • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                                              • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                              Molina Healthcare of California Molina Medicare Options Plus (HMO SNP) (H5810-001) HMO

                                                                                                Premium and Other Important Information

                                                                                                • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                                • $0 annual deductible.*
                                                                                                • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                                • $6 700 out-of-pocket limit for Medicare-covered services. However in this plan you will have no cost sharing responsibility for Medicare-covered services based on your level of Medicaid eligibility.
                                                                                                • $0 monthly plan premium*

                                                                                                Doctor Office Visits

                                                                                                • Authorization rules may apply.
                                                                                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                                • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                                                • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                                Molina Healthcare of California Molina Medicare Options (HMO) (H5810-002) HMO

                                                                                                  Premium and Other Important Information

                                                                                                  • $3 350 out-of-pocket limit for Medicare-covered services.
                                                                                                  • $29 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                  Doctor Office Visits

                                                                                                  • Authorization rules may apply.
                                                                                                  • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                  • $25 copay for each in-area network urgent care Medicare-covered visit
                                                                                                  • $10 copay for each specialist visit for Medicare-covered benefits.
                                                                                                  Positive Healthcare Partners Positive Healthcare Partners (HMO SNP) (H5852-001) HMO

                                                                                                    Premium and Other Important Information

                                                                                                    • In this plan you will have no cost sharing responsibility for Medicare-covered services and Non-Medicare Supplemental Services.
                                                                                                    • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                    Doctor Office Visits

                                                                                                    • Authorization rules may apply.
                                                                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                    • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.
                                                                                                    • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                                                    Care1st Medicare Advantage Plan Care1st TotalDual Plan (HMO SNP) (H5928-001) HMO

                                                                                                      Premium and Other Important Information

                                                                                                      • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                                      • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                                      • $1 out-of-pocket limit for Medicare-covered services.*
                                                                                                      • $30.8 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                                                                      Doctor Office Visits

                                                                                                      • Authorization rules may apply.
                                                                                                      • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                                      • $0 copay for the cost of each in-area network urgent care Medicare-covered visit.*
                                                                                                      • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                                      Care1st Medicare Advantage Plan Care1st AdvantageOptimum Plan (HMO) (H5928-004) HMO

                                                                                                        Premium and Other Important Information

                                                                                                        • Care1st Medicare Advantage Plan will reduce your monthly Medicare Part B premium by up to $ 10.00.
                                                                                                        • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                                        • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                        • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                        Doctor Office Visits

                                                                                                        • Authorization rules may apply.
                                                                                                        • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                        • $15 copay for each in-area network urgent care Medicare-covered visit
                                                                                                        • $5 copay for each specialist visit for Medicare-covered benefits.
                                                                                                        Care1st Medicare Advantage Plan Care1st TotalAdvantage Plan (HMO) (H5928-018) HMO

                                                                                                          Premium and Other Important Information

                                                                                                          • Care1st Medicare Advantage Plan will reduce your monthly Medicare Part B premium by up to $ 30.00.
                                                                                                          • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                                          • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                          • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                          Doctor Office Visits

                                                                                                          • Authorization rules may apply.
                                                                                                          • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                          • $15 copay for each in-area network urgent care Medicare-covered visit
                                                                                                          • $15 copay for each specialist visit for Medicare-covered benefits.
                                                                                                          MD Care Healthplan Advantage I MAPD (HMO) (H7731-001) HMO

                                                                                                            Premium and Other Important Information

                                                                                                            • $2 400 out-of-pocket limit for Medicare-covered services.
                                                                                                            • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                            • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                            Doctor Office Visits

                                                                                                            • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                            • $10 copay for each specialist visit for Medicare-covered benefits.
                                                                                                            MD Care Healthplan Advantage Select MA (HMO) (H7731-007) HMO

                                                                                                              Premium and Other Important Information

                                                                                                              • MD Care Healthplan will reduce your monthly Medicare Part B premium by up to $ 35.20.
                                                                                                              • $1 000 out-of-pocket limit for Medicare-covered services.
                                                                                                              • $0.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                              • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay a higher premium because of their yearly income (over $85 000 for singles $170 000 for married couples). For more i

                                                                                                              Doctor Office Visits

                                                                                                              • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                              • $0 copay for each specialist doctor visit for Medicare-covered benefits.
                                                                                                              MD Care Healthplan Preferred Dual SNP (HMO SNP) (H7731-008) HMO

                                                                                                                Premium and Other Important Information

                                                                                                                • * Depending on your level of Medicaid eligibility you may not have any cost-sharing responsibility for original Medicare services
                                                                                                                • MD Care Healthplan will reduce your monthly Medicare Part B premium by up to $ 5.20.
                                                                                                                • ** Please consult with your plan about cost sharing when receiving services from out-of-network providers.
                                                                                                                • $100 out-of-pocket limit for Medicare-covered services.*
                                                                                                                • $0 monthly plan premium in addition to your monthly Medicare Part B premium.*

                                                                                                                Doctor Office Visits

                                                                                                                • $0 copay for each primary care doctor visit for Medicare-covered benefits.*
                                                                                                                • $0 copay for each specialist doctor visit for Medicare-covered benefits.*
                                                                                                                Anthem Blue Cross Anthem Medicare Preferred Standard (PPO) (H8552-001) Local Preferred Provider Organization

                                                                                                                  Premium and Other Important Information

                                                                                                                  • Package: 1 - Preventive Dental Package:
                                                                                                                  • Package: 2 - Comprehensive Dental and Vision Package:
                                                                                                                  • Package: 3 - Combination Package:
                                                                                                                  • $12 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                                                  • $32 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                                                                                                                  • $45 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services Acupuncture Preventive Dental Compreh
                                                                                                                  • $3 400 out-of-pocket limit for Medicare-covered services.
                                                                                                                  • $300 annual deductible. Contact the plan for services that apply.
                                                                                                                  • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                                  • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co
                                                                                                                  • Some physicians providers and suppliers that are out of a plan's network (i.e. out-of-network) accept "assignment" from Medicare and will only charge up to a Medicare-approved amount. If you choose to see an out-of-network physician who does NOT accept

                                                                                                                  Doctor Office Visits

                                                                                                                  • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                                  • $45 copay for each in-area network urgent care Medicare-covered visit
                                                                                                                  • $45 copay for each specialist visit for Medicare-covered benefits.
                                                                                                                  • $35 copay for each primary care doctor visit
                                                                                                                  • $55 copay for each specialist visit
                                                                                                                  SCAN Health Plan SCAN Healthy at Home (HMO SNP) (H9104-006) HMO

                                                                                                                    Premium and Other Important Information

                                                                                                                    • Package: 1 - Dental Buy-Up #1:
                                                                                                                    • Package: 2 - Dental Buy-Up #2:
                                                                                                                    • $8 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                                                    • $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental
                                                                                                                    • $6 700 out-of-pocket limit for Medicare-covered services.
                                                                                                                    • $0 monthly plan premium in addition to your monthly Medicare Part B premium.
                                                                                                                    • Most people will pay the standard monthly Part B premium in addition to their MA plan premium. However some people will pay higher Part B and Part D premiums because of their yearly income (over $85 000 for singles $170 000 for married co

                                                                                                                    Doctor Office Visits

                                                                                                                    • Authorization rules may apply.
                                                                                                                    • $0 copay for each primary care doctor visit for Medicare-covered benefits.
                                                                                                                    • $35 copay for each in-area network urgent care Medicare-covered visit
                                                                                                                    • $5 copay for each specialist visit for Medicare-covered benefits.

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