2016 Medicare Plans

Independent Health's
Encompass 65® Essential HMO-POS Plan
Monthly
Premium
$0
 
Primary/Specialty Copay
(In-Network)
$15 / $45
 
Inpatient Hospital Copay
(In-Network)
Days 1-6: $295 per day
Days 7-90 $0
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
$175 deductible on Tiers 3, 4,& 5 only
$8 / $20 / $47 / $100 / 29% to initial coverage limit of $3,310
Independent Health's (Must reside in Erie or Niagara Counties)
Network Advantage® HMO Plan
Monthly Premium
$50
 
Primary/Specialty Copay
(In-Network)
$0 (must use an in-network Network Advantage PCP) / $30
 
Inpatient Hospital Copay
(In-Network)
Tier A: $400 per admission
Tier B: $900 per admission
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$4 / $10 / $45 / $90 / 33% to initial coverage limit of $3,310
Independent Health's (Must reside in Allegany, Cattaraugus, Chautauqua,
Genesee, Wyoming or Orleans counties)
Encompass 65® Select HMO-POS Plan
Monthly Premium
$41
 
Primary/Specialty Copay
(In-Network)
$15 / $45
 
Inpatient Hospital Copay
(In-Network)
$850 per admission
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$4 / $15 / $45 / $95 / 33% to initial coverage limit of $3,310
Independent Health's
Encompass 65® Basic HMO-POS Plan
Monthly Premium
$111
 
Primary/Specialty Copay
(In-Network)
$10 / $30
 
Inpatient Hospital Copay
(In-Network)
$700 per admission
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$4 / $10 / $47 / $75 / 33% to initial coverage limit of $3,310
Independent Health's
Medicare Passport® Advantage PPO Plan
Monthly Premium
$125
 
Primary/Specialty Copay
(In-Network)
$20 / $35
 
Inpatient Hospital Copay
(In-Network)
Days 1-7: $250 per day
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$4 / $12 / $45 / $90 / 33% to initial coverage limit of $3,310
Independent Health's
Encompass 65® HMO (without prescription coverage)
Monthly Premium
$0
 
Primary/Specialty Copay
(In-Network)
$10 / $25
 
Inpatient Hospital Copay
(In-Network)
Days 1-6: $295 per day
Days 7-90: $0
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No prescription benefit.
Special Needs Plans
Independent Health's
Medicare Family Choice® HMO-SNP Plan
This plan is specifically designed to help you stay involved with the care of your loved one living in a nursing home or an assisted living facility with the help of a coordinated care team.
 

Already an Independent Health Medicare Advantage plan member?

View your 2016 plan information »
 

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Disclaimers
Independent Health is a Medicare Advantage organization with a Medicare contract offering HMO, HMO-SNP, HMO-POS and PPO plans. Enrollment in Independent Health depends on contract renewal. Benefits vary by plan. This information is not a complete description of benefits. For more information, contact the plan. See Evidence of Coverage for complete details. Benefits may change on January 1 of each year. Limitations, copayments, and restrictions may apply. Benefits, formulary, premium and/or copayments/coinsurance may change on January 1 of each year.
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Y0042_C5683 Approved
Last Updated: 11/17/2016