2018 Medicare Plans

Independent Health's
Encompass 65® Core HMO Plan
Monthly
Premium
$65
 
Primary/Specialty Copay
(In-Network)
$0 / $50
 
Inpatient Hospital Copay
(In-Network)
Days 1-4: $375 per day
Days 5-90: $0
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
$150 deductible on tiers 3, 4 & 5 only
$0/$20/$47/50%/29%
to initial coverage limit of $3,750
Independent Health's
Encompass 65® Basic HMO
Monthly Premium
$118
 
Primary/Specialty Copay
(In-Network)
$0 / $25
 
Inpatient Hospital Copay
(In-Network)
Days 1-6: $225 per day
Days 7-90: $0
($1800 Annual Member Copay Maximum)
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$0/$10/$47/50%/33%
to initial coverage limit
of $3,750
Independent Health's
Medicare Passport® Advantage PPO
PLEASE NOTE THERE IS A SPECIAL NETWORK WITH THIS PPO PLAN ONLY – SPEAK WITH A REDSHIRT FOR DETAILS.
Monthly Premium
$87
 
Primary/Specialty Copay
(In-Network)
$0 / $45
 
Inpatient Hospital Copay
(In-Network)
Days 1-7: $250 per day
Days 8-90: $0
 
Part D Prescription Benefit
Tier 1 / 2 / 3 / 4 / 5
No deductible
$0/$20/$47/50%/33%
to initial coverage limit
of $3,750
Independent Health's
Encompass 65® HMO (without prescription coverage)
Monthly Premium
$0
 
Primary/Specialty Copay
(In-Network)
$0 / $25
 
Inpatient Hospital Copay
(In-Network)
Days 1-6: $275 per day
Days 7-90: $0
($1800 Annual Member Copay Maximum)
 
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.
 

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Multi-Language Insert (Nondiscrimination statement and language assistance services)    Nondiscrimination Notice
 

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. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or copayments may change on January 1 of each year. The provider network may change at any time. You will receive notice when necessary. You must continue to pay your Medicare Part B premium.
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Y0042_C5900 Pending
Last Updated 10/1/2017