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Kansas MedicareAdvantage Plans

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Medicare Advantage Plans in Cheyenne County, Kansas

Below are Medicare Advantage plans available to residents of Cheyenne county, Kansas. 5 carriers offer 22 plans throughout the county of Cheyenne. Residents may choose plans from carriers such as Rocky Mountain Health Plans, Humana Insurance Company and WindsorSterling. 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 Cheyenne county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Cheyenne

Carrier Plan Title Plan Type
Rocky Mountain Health Plans Rocky Mountain Plus Plan (Cost) (H0602-003) Cost Plan

    Premium and Other Important Information

    • Package: 1 - Dental Services:
    • Package: 2 - Vision Services:
    • $18 monthly premium in addition to your $156.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
    • $12 monthly premium in addition to your $156.80 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
    • $1 500 plan coverage limit every year for these benefits.
    • $156.80 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

    • $15 copay for each primary care doctor visit for Medicare-covered benefits.
    • $35 copay for each in-area network urgent care Medicare-covered visit
    • $35 copay for each specialist visit for Medicare-covered benefits.
    Rocky Mountain Health Plans Rocky Mountain Standard Plan (Cost) (H0602-007) Cost Plan

      Premium and Other Important Information

      • $150 annual deductible. Contact the plan for services that apply.
      • Package: 1 - Dental Services:
      • Package: 2 - Vision Services:
      • $18 monthly premium in addition to your $42.90 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
      • $12 monthly premium in addition to your $42.90 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
      • $1 500 plan coverage limit every year for these benefits.
      • $42.90 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

      • $20 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.
      Rocky Mountain Health Plans Rocky Mountain Plus Plan + Rx (Cost) (H0602-019) Cost Plan

        Premium and Other Important Information

        • Package: 1 - Dental Services:
        • Package: 2 - Vision Services:
        • $18 monthly premium in addition to your $246.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
        • $12 monthly premium in addition to your $246.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
        • $1 500 plan coverage limit every year for these benefits.
        • $246.2 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

        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
        • $35 copay for each in-area network urgent care Medicare-covered visit
        • $35 copay for each specialist visit for Medicare-covered benefits.
        Rocky Mountain Health Plans Rocky Mountain Standard Plan + Rx (Cost) (H0602-020) Cost Plan

          Premium and Other Important Information

          • $150 annual deductible. Contact the plan for services that apply.
          • Package: 1 - Dental Services:
          • Package: 2 - Vision Services:
          • $18 monthly premium in addition to your $99.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
          • $12 monthly premium in addition to your $99.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
          • $1 500 plan coverage limit every year for these benefits.
          • $99.1 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

          • $20 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.
          Rocky Mountain Health Plans AB Basic Plan (Cost) (H0602-026) Cost Plan

            Premium and Other Important Information

            • In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply.
            • $5.00 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

            • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
            • 20% of the cost for each in-area network urgent care Medicare-covered visit
            • 20% of the cost for each specialist visit for Medicare-covered benefits.
            Rocky Mountain Health Plans Rocky Mountain Thrifty Plan (Cost) (H0602-027) Cost Plan

              Premium and Other Important Information

              • $500 annual deductible. Contact the plan for services that apply.
              • Package: 1 - Dental Services:
              • Package: 2 - Vision Services:
              • $18 monthly premium in addition to your $34 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
              • $12 monthly premium in addition to your $34 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
              • $1 500 plan coverage limit every year for these benefits.
              • $34.00 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

              • $20 copay for each primary care doctor visit for Medicare-covered benefits.
              • $50 copay for each in-area network urgent care Medicare-covered visit
              • $50 copay for each specialist visit for Medicare-covered benefits.
              Rocky Mountain Health Plans Rocky Mountain Thrifty Plan + Rx (Cost) (H0602-039) Cost Plan

                Premium and Other Important Information

                • $500 annual deductible. Contact the plan for services that apply.
                • Package: 1 - Dental Services:
                • Package: 2 - Vision Services:
                • $18 monthly premium in addition to your $74.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                • $12 monthly premium in addition to your $74.20 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                • $1 500 plan coverage limit every year for these benefits.
                • $74.2 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

                • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                • $50 copay for each in-area network urgent care Medicare-covered visit
                • $50 copay for each specialist visit for Medicare-covered benefits.
                Rocky Mountain Health Plans B Basic Plan (Cost) (H0602-040) Cost Plan

                  Premium and Other Important Information

                  • In 2012 the annual Part B deductible amount is $140. Contact the plan for services that apply.
                  • $5.00 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

                  • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
                  • 20% of the cost for each in-area network urgent care Medicare-covered visit
                  • 20% of the cost for each specialist visit for Medicare-covered benefits.
                  Rocky Mountain Health Plans B Standard Plan (Cost) (H0602-041) Cost Plan

                    Premium and Other Important Information

                    • $73.00 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

                    • $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.
                    Rocky Mountain Health Plans Rocky Mountain Green Plan (Cost) (H0602-042) Cost Plan

                      Premium and Other Important Information

                      • $500 annual deductible. Contact the plan for services that apply.
                      • Package: 1 - Dental Services:
                      • Package: 2 - Vision Services:
                      • $18 monthly premium in addition to your $8 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                      • $12 monthly premium in addition to your $8 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
                      • $1 500 plan coverage limit every year for these benefits.
                      • $6 700 out-of-pocket limit for Medicare-covered services.
                      • $8.00 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

                      • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                      • $40 copay for each in-area network urgent care Medicare-covered visit
                      • $40 copay for each specialist visit for Medicare-covered benefits.
                      Rocky Mountain Health Plans Rocky Mountain Green Plan + Rx (Cost) (H0602-043) Cost Plan

                        Premium and Other Important Information

                        • $500 annual deductible. Contact the plan for services that apply.
                        • Package: 1 - Dental Services:
                        • Package: 2 - Vision Services:
                        • $18 monthly premium in addition to your $48.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                        • $12 monthly premium in addition to your $48.10 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Wear
                        • $1 500 plan coverage limit every year for these benefits.
                        • $6 700 out-of-pocket limit for Medicare-covered services.
                        • $48.1 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

                        • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                        • $40 copay for each in-area network urgent care Medicare-covered visit
                        • $40 copay for each specialist visit for Medicare-covered benefits.
                        Humana Insurance Company Humana Gold Choice H2944-013 (PFFS) (H2944-013) Private Fee for Service

                          Premium and Other Important Information

                          • Package: 1 - MyOption Dental High PPO:
                          • Package: 2 - MyOption Dental Low PPO:
                          • Package: 3 - MyOption Vision:
                          • Package: 4 - MyOption Plus:
                          • $27 monthly premium in addition to your $69 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                          • $17 monthly premium in addition to your $69 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                          • $15 monthly premium in addition to your $69 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                          • $28 monthly premium in addition to your $69 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                          • $1 500 plan coverage limit every year for these benefits.
                          • $1 000 plan coverage limit every year for these benefits.
                          • $290 plan coverage limit every year for these benefits.
                          • Unless otherwise noted out-of-network services not covered.
                          • $5 000 out-of-pocket limit for Medicare-covered services.
                          • $69 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
                          • This plan does not allow providers to balance bill (charging more than your cost share amount).

                          Doctor Office Visits

                          • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                          • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                          • $35 copay for each specialist visit for Medicare-covered benefits.
                          Humana Insurance Company Humana Gold Choice H2944-197 (PFFS) (H2944-197) Private Fee for Service

                            Premium and Other Important Information

                            • Package: 1 - MyOption Dental High PPO:
                            • Package: 2 - MyOption Dental Low PPO:
                            • Package: 3 - MyOption Vision:
                            • Package: 4 - MyOption Plus:
                            • Package: 5 - MyOption Fitness Well Being:
                            • $27 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
                            • $17 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
                            • $15 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                            • $28 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
                            • $30 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Supplemental Education/Wellness Programs
                            • $1 500 plan coverage limit every year for these benefits.
                            • $1 000 plan coverage limit every year for these benefits.
                            • $290 plan coverage limit every year for these benefits.
                            • Unless otherwise noted out-of-network services not covered.
                            • $162 annual deductible. Contact the plan for services that apply.
                            • $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
                            • This plan does not allow providers to balance bill (charging more than your cost share amount).

                            Doctor Office Visits

                            • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                            • 20% of the cost for each primary care doctor visit for Medicare-covered benefits.
                            • 20% of the cost for each specialist visit for Medicare-covered benefits.
                            Humana Insurance Company Humana Gold Choice H2944-204 (PFFS) (H2944-204) Private Fee for Service

                              Premium and Other Important Information

                              • Package: 1 - MyOption Dental High PPO:
                              • Package: 2 - MyOption Dental Low PPO:
                              • Package: 3 - MyOption Vision:
                              • Package: 4 - MyOption Plus:
                              • Package: 5 - MyOption Fitness Well Being:
                              • $27 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                              • $17 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                              • $15 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
                              • $28 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
                              • $30 monthly premium in addition to your $49 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Supplemental Education/Wellness Programs
                              • $1 500 plan coverage limit every year for these benefits.
                              • $1 000 plan coverage limit every year for these benefits.
                              • $290 plan coverage limit every year for these benefits.
                              • Unless otherwise noted out-of-network services not covered.
                              • $6 700 out-of-pocket limit for Medicare-covered services.
                              • $49 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
                              • This plan does not allow providers to balance bill (charging more than your cost share amount).

                              Doctor Office Visits

                              • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                              • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                              • $40 copay for each specialist visit for Medicare-covered benefits.
                              WindsorSterling WindsorSterling Gold Access Plan (PFFS) (H5006-017) Private Fee for Service

                                Premium and Other Important Information

                                • $4 000 out-of-pocket limit. All plan services included.
                                • $60 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $75 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $70 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $55 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $59 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $80 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $62 monthly plan premium in addition to your monthly Medicare Part B premium.
                                • $85 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
                                • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                Doctor Office Visits

                                • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                • $30 copay for each specialist visit for Medicare-covered benefits.
                                WindsorSterling WindsorSterling Silver Access Plan (PFFS) (H5006-018) Private Fee for Service

                                  Premium and Other Important Information

                                  • $4 000 out-of-pocket limit. All plan services included.
                                  • $30.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $45.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $40.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $25.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $50.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $49.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $32.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $29.00 monthly plan premium in addition to your monthly Medicare Part B premium.
                                  • $55.00 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
                                  • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                  Doctor Office Visits

                                  • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                  • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                  • $30 copay for each specialist visit for Medicare-covered benefits.
                                  Universal American Corp. Today's Options Premier 400 (PFFS) (H5421-056) Private Fee for Service

                                    Premium and Other Important Information

                                    • $6 700 out-of-pocket limit for Medicare-covered services.
                                    • $75.00 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
                                    • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                    Doctor Office Visits

                                    • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                    • $25 copay for each primary care doctor visit for Medicare-covered benefits.
                                    • $50 copay for each specialist visit for Medicare-covered benefits.
                                    Universal American Corp. Today's Options Premier Plus 250A (PFFS) (H5421-068) Private Fee for Service

                                      Premium and Other Important Information

                                      • $3 250 out-of-pocket limit for Medicare-covered services.
                                      • $165 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
                                      • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                      Doctor Office Visits

                                      • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                      • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                      • $30 copay for each specialist visit for Medicare-covered benefits.
                                      Universal American Corp. Today's Options Premier Plus 450E (PFFS) (H5421-074) Private Fee for Service

                                        Premium and Other Important Information

                                        • $6 700 out-of-pocket limit for Medicare-covered services.
                                        • $108 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
                                        • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                        Doctor Office Visits

                                        • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                        • $25 copay for each primary care doctor visit for Medicare-covered benefits.
                                        • $50 copay for each specialist visit for Medicare-covered benefits.
                                        Universal American Corp. Today's Options Premier 200 (PFFS) (H5421-210) Private Fee for Service

                                          Premium and Other Important Information

                                          • $3 250 out-of-pocket limit for Medicare-covered services.
                                          • $110.00 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
                                          • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                          Doctor Office Visits

                                          • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                          • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                                          • $30 copay for each specialist visit for Medicare-covered benefits.
                                          UnitedHealthcare UnitedHealthcare MedicareDirect Essential (PFFS) (H5435-001) Private Fee for Service

                                            Premium and Other Important Information

                                            • $6 200 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
                                            • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                            Doctor Office Visits

                                            • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                            • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                                            • $45 copay for each specialist visit for Medicare-covered benefits.
                                            UnitedHealthcare UnitedHealthcare MedicareDirect Rx (PFFS) (H5435-024) Private Fee for Service

                                              Premium and Other Important Information

                                              • $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
                                              • This plan does not allow providers to balance bill (charging more than your cost share amount).

                                              Doctor Office Visits

                                              • You may go to any doctor specialist or hospital that accepts the plan's terms and conditions of payment.
                                              • $20 copay for each primary care doctor visit for Medicare-covered benefits.
                                              • $45 copay for each specialist visit for Medicare-covered benefits.

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