Disclaimers
* Member pays 20% for genetic testing.
This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care requirement and resides in a participating nursing home for 90 days or more. Or, members must qualify for an institutional level of care as defined by the state of New York. Must be a resident of a participating assisted living facility located in Western New York, and not live outside the affiliated facility for more than 30 days.
This plan requires the use of participating providers, except in the case of emergency care, urgent care or out of area renal dialysis. This information is not a complete description of benefits. Call (716) 250-4401 or 1-800-665-1502 (TTY users call 711) for more information.
** $10,000 annual maximum plan limit for emergency care, urgent care or ambulance outside the USA and its territories.
***Allowance is made available by quarter. Allowance carries over quarter to quarter, however does not carry over plan year to plan year. Costs over the allowed amount are the member’s responsibility. This benefit can only be used for covered items through NationsOTC.®
IN = In-Network, OON = Out-of-Network
Independent Health has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2026 based on a review of Independent Health’s Model of Care.
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