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New York MedicareAdvantage Plans

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Medicare Advantage Plans in Cattaraugus County, New York

Below are Medicare Advantage plans available to residents of Cattaraugus county, New York. 8 carriers offer 29 plans throughout the county of Cattaraugus. Residents may choose plans from carriers such as Humana Insurance Company of New York, Universal American Corp. and Excellus Health Plan Inc. 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 Cattaraugus county that is right for you complete the form at the top of the page.

Medicare Advantage Health Plans in the county of Cattaraugus

Carrier Plan Title Plan Type
Humana Insurance Company of New York Humana Gold Choice H1291-001 (PFFS) (H1291-001) Private Fee for Service

    Premium and Other Important Information

    • Package: 1 - MyOption Vision:
    • Package: 2 - MyOption Enhanced Dental PPO:
    • Package: 3 - MyOption Healthy Back:
    • $15 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
    • $36 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
    • $16 monthly premium in addition to your $41 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
    • $290 plan coverage limit every year for these benefits.
    • $500 plan coverage limit every year for these benefits.
    • $5 000 out-of-pocket limit for Medicare-covered services.
    • $41 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.
    • $40 copay for each in-area network urgent care Medicare-covered visit
    • $40 copay for each specialist visit for Medicare-covered benefits.
    • $15 copay for each primary care doctor visit
    • $40 copay for each specialist visit
    Humana Insurance Company of New York Humana Gold Choice H1291-003 (PFFS) (H1291-003) 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 Healthy Back:
      • $39 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
      • $22 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
      • $34 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
      • $16 monthly premium in addition to your $0 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
      • $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.
      • $500 plan coverage limit every year for these benefits.
      • $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 in-area network urgent care Medicare-covered visit
      • 20% of the cost for each specialist visit for Medicare-covered benefits.
      • 20% of the cost for each primary care doctor visit
      • 20% of the cost for each specialist visit
      Humana Insurance Company of New York Humana Gold Choice H1291-007 (PFFS) (H1291-007) 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 Healthy Back:
        • $39 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
        • $22 monthly premium in addition to your $31 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 $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Eye Exams Eye Wear
        • $34 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental Eye Exams Eye Wear
        • $16 monthly premium in addition to your $31 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
        • $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.
        • $500 plan coverage limit every year for these benefits.
        • $162 annual deductible. Contact the plan for services that apply.
        • $6 700 out-of-pocket limit for Medicare-covered services.
        • $31 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% 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.
        • 20% of the cost for each primary care doctor visit
        • 20% of the cost for each specialist visit
        Universal American Corp. Today's Options Premier 100 (PFFS) (H2816-002) Private Fee for Service

          Premium and Other Important Information

          • $3 400 out-of-pocket limit for Medicare-covered services.
          • $47.00 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.
          • $35 copay for each in-area network urgent care Medicare-covered visit
          • $30 copay for each specialist visit for Medicare-covered benefits.
          • $15 copay for each primary care doctor visit
          • $35 copay for each specialist visit
          Universal American Corp. Today's Options Premier 400 (PFFS) (H2816-008) Private Fee for Service

            Premium and Other Important Information

            • $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.
            • $25 copay for each primary care doctor visit for Medicare-covered benefits.
            • $35 copay for each in-area network urgent care Medicare-covered visit
            • $50 copay for each specialist visit for Medicare-covered benefits.
            • $30 copay for each primary care doctor visit
            • $60 copay for each specialist visit
            Universal American Corp. Today's Options Premier Plus 150A (PFFS) (H2816-014) Private Fee for Service

              Premium and Other Important Information

              • $3 400 out-of-pocket limit for Medicare-covered services.
              • $100 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.
              • $35 copay for each in-area network urgent care Medicare-covered visit
              • $30 copay for each specialist visit for Medicare-covered benefits.
              • $15 copay for each primary care doctor visit
              • $35 copay for each specialist visit
              Universal American Corp. Today's Options Premier Plus 450B (PFFS) (H2816-020) Private Fee for Service

                Premium and Other Important Information

                • $6 700 out-of-pocket limit for Medicare-covered services.
                • $35 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.
                • $35 copay for each in-area network urgent care Medicare-covered visit
                • $50 copay for each specialist visit for Medicare-covered benefits.
                • $30 copay for each primary care doctor visit
                • $60 copay for each specialist visit
                Excellus Health Plan Inc Univera Medicare PPO Plan 102 (PPO) (H3335-002) Local Preferred Provider Organization

                  Premium and Other Important Information

                  • $4 000 out-of-pocket limit. All plan services included.
                  • $10 000 out-of-pocket limit. All plan services included.
                  • $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
                  • 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

                  • $20 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.
                  • $25 copay for each primary care doctor visit
                  • $45 copay for each specialist visit
                  Independent Health Independent Health Medicare Passport Premier (PPO) (H3344-003) Local Preferred Provider Organization

                    Premium and Other Important Information

                    • $3 400 out-of-pocket limit for Medicare-covered services.
                    • $5 100 out-of-pocket limit for Medicare-covered services.
                    • $173 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

                    • $5 copay for each primary care doctor visit for Medicare-covered benefits.
                    • $30 copay for each in-area network urgent care Medicare-covered visit
                    • $20 copay for each specialist visit for Medicare-covered benefits.
                    • $30 copay for each primary care doctor visit
                    • $30 copay for each specialist visit
                    Independent Health Independent Health Medicare Passport Advantage (PPO) (H3344-005) Local Preferred Provider Organization

                      Premium and Other Important Information

                      • $3 400 out-of-pocket limit for Medicare-covered services.
                      • $500 annual deductible. Contact the plan for services that apply.
                      • $5 100 out-of-pocket limit for Medicare-covered services.
                      • $65 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

                      • $20 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.
                      • $40 copay for each primary care doctor visit
                      • $40 copay for each specialist visit
                      Independent Health Independent Health Medicare Passport Basic (PPO) (H3344-006) Local Preferred Provider Organization

                        Premium and Other Important Information

                        • $3 400 out-of-pocket limit for Medicare-covered services.
                        • $250 annual deductible. Contact the plan for services that apply.
                        • $5 100 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
                        • 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

                        • $25 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.
                        • $40 copay for each primary care doctor visit
                        • $40 copay for each specialist visit
                        Excellus Health Plan Inc SeniorChoice Select (HMO-POS) (H3351-001) HMO with POS Option

                          Premium and Other Important Information

                          • $3 400 out-of-pocket limit. All plan services included.
                          • $80.00 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.
                          • $35 copay for each in-area network urgent care Medicare-covered visit
                          • $35 copay for each specialist visit for Medicare-covered benefits.
                          Excellus Health Plan Inc SeniorChoice Secure (HMO-POS) (H3351-002) HMO with POS Option

                            Premium and Other Important Information

                            • $3 400 out-of-pocket limit. All plan services included.
                            • $114 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.
                            Excellus Health Plan Inc SeniorChoice Value (HMO) (H3351-010) 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

                              • $20 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.
                              Excellus Health Plan Inc SeniorChoice Value Plus (HMO) (H3351-012) HMO

                                Premium and Other Important Information

                                • $3 400 out-of-pocket limit. All plan services included.
                                • $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

                                • $20 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.
                                Independent Health Independent Health Encompass 65 (HMO) (H3362-003) HMO

                                  Premium and Other Important Information

                                  • $3 400 out-of-pocket limit for Medicare-covered services.
                                  • $39.8 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.
                                  • $30 copay for each in-area network urgent care Medicare-covered visit
                                  • $25 copay for each specialist visit for Medicare-covered benefits.
                                  Independent Health Independent Health Encompass 65 (HMO) (H3362-016) HMO

                                    Premium and Other Important Information

                                    • $3 400 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

                                    • $10 copay for each primary care doctor visit for Medicare-covered benefits.
                                    • $30 copay for each in-area network urgent care Medicare-covered visit
                                    • $25 copay for each specialist visit for Medicare-covered benefits.
                                    Independent Health Independent Health Encompass 65 Basic (HMO) (H3362-017) 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

                                      • $15 copay for each primary care doctor visit for Medicare-covered benefits.
                                      • $35 copay for each in-area network urgent care Medicare-covered visit
                                      • $30 copay for each specialist visit for Medicare-covered benefits.
                                      Independent Health Independent Health Medicare Family Choice (HMO SNP) (H3362-020) HMO

                                        Premium and Other Important Information

                                        • $3 400 out-of-pocket limit for Medicare-covered services.
                                        • $37 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.
                                        • $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.
                                        BlueCross BlueShield of WNY OR BlueShield of NENY BlueCross BlueShield Senior Blue HMO 651 PartD (HMO) (H3384-019) HMO

                                          Premium and Other Important Information

                                          • Package: 1 - Optional Dental Benefit:
                                          • $10 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
                                          • $250 plan coverage limit every year for these benefits.
                                          • $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

                                          • $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.
                                          BlueCross BlueShield of WNY OR BlueShield of NENY BlueCross BlueShield Senior Blue HMO 601 (HMO) (H3384-022) HMO

                                            Premium and Other Important Information

                                            • Package: 1 - Optional Dental Benefit:
                                            • $10 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
                                            • $250 plan coverage limit every year for these benefits.
                                            • $3 400 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

                                            • $10 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.
                                            BlueCross BlueShield of WNY OR BlueShield of NENY BlueCross BlueShield Senior Blue HMO 653 PartD (HMO) (H3384-041) HMO

                                              Premium and Other Important Information

                                              • Package: 1 - Optional Dental Benefit:
                                              • $10 monthly premium in addition to your $95 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                              • $250 plan coverage limit every year for these benefits.
                                              • $3 400 out-of-pocket limit for Medicare-covered services.
                                              • $95 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
                                              • $25 copay for each specialist visit for Medicare-covered benefits.
                                              BlueCross BlueShield of WNY or BlueShield of NENY BlueCross BlueShield Forever Blue Medicare PPO 701 (PPO) (H5526-002) Local Preferred Provider Organization

                                                Premium and Other Important Information

                                                • Package: 1 - Optional Dental Benefit:
                                                • $10 monthly premium in addition to your $40 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                • $250 plan coverage limit every year for these benefits.
                                                • $3 400 out-of-pocket limit for Medicare-covered services.
                                                • $5 100 out-of-pocket limit for Medicare-covered services.
                                                • $40.00 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
                                                • 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.
                                                • $25 copay for each in-area network urgent care Medicare-covered visit
                                                • $25 copay for each specialist visit for Medicare-covered benefits.
                                                • $30 copay for each primary care doctor visit
                                                • $30 copay for each specialist visit
                                                BlueCross BlueShield of WNY or BlueShield of NENY BlueCross BlueShield Forever Blue Medicare PPO 751 (PPO) (H5526-004) Local Preferred Provider Organization

                                                  Premium and Other Important Information

                                                  • Package: 1 - Optional Dental Benefit:
                                                  • $10 monthly premium in addition to your $111 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                  • $250 plan coverage limit every year for these benefits.
                                                  • $5 100 out-of-pocket limit for Medicare-covered services.
                                                  • $7 000 out-of-pocket limit for Medicare-covered services.
                                                  • $111 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

                                                  • $25 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.
                                                  • $30 copay for each primary care doctor visit
                                                  • $40 copay for each specialist visit
                                                  Humana Insurance Company of New York HumanaChoice H5970-001 (PPO) (H5970-001) Local Preferred Provider Organization

                                                    Premium and Other Important Information

                                                    • Package: 1 - MyOption Enhanced Dental PPO:
                                                    • Package: 2 - MyOption Healthy Back:
                                                    • $36 monthly premium in addition to your $19 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                    • $16 monthly premium in addition to your $19 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
                                                    • $500 plan coverage limit every year for these benefits.
                                                    • $4 000 out-of-pocket limit for Medicare-covered services.
                                                    • $6 000 out-of-pocket limit for Medicare-covered services.
                                                    • $19 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

                                                    • $10 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.
                                                    • $10 copay for each primary care doctor visit
                                                    • $35 copay for each specialist visit
                                                    Humana Insurance Company of New York Humana Reader's Digest Healthy Living Plan (PPO) (H5970-004) Local Preferred Provider Organization

                                                      Premium and Other Important Information

                                                      • Package: 1 - MyOption Enhanced Dental PPO:
                                                      • Package: 2 - MyOption Healthy Back:
                                                      • $36 monthly premium in addition to your $119 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Preventive Dental Comprehensive Dental
                                                      • $16 monthly premium in addition to your $119 monthly plan premium and the monthly Medicare Part B premium for the following optional benefits: Chiropractic Services
                                                      • $500 plan coverage limit every year for these benefits.
                                                      • $5 000 out-of-pocket limit for Medicare-covered services.
                                                      • $7 500 out-of-pocket limit for Medicare-covered services.
                                                      • $119 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

                                                      • $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.
                                                      • $0 copay for each primary care doctor visit
                                                      • $0 copay for each specialist visit
                                                      Total Senior Care Inc. Total Senior Care - Dual (PACE) (H8800-001) National PACE
                                                        Total Senior Care Inc. Total Senior Care - Medicare Small Only (PACE) (H8800-002) National PACE
                                                          ActiveSaver MSA or BlueSaver MSA BlueSaver MSA (MSA) (H9788-001) Medical Savings Account

                                                            Premium and Other Important Information

                                                            • Balance billing means that a provider may charge and bill you more than the plan's payment amount for services There is a limit on what providers may charge for Medicare-covered services
                                                            • $4 750 annual deductible
                                                            • Note that only Medicare-covered services will count toward your annual deductible.
                                                            • Medicare will deposit $3 000 into your bank account.
                                                            • You will not have a monthly plan premium. Medicare pays the monthly plan premium for the Medicare MSA Plan.
                                                            • 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
                                                            • Balance billing counts towards your plan deductible.

                                                            Doctor Office Visits

                                                            • Once you reach the plan deductible Medicare MSA plans cover Original Medicare benefits. Co-pay for Medicare MSAs is $0 once deductible is met.

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