Pay Bill2025 Encompass 65® Direct HMO
Plan Highlights
MONTHLY PREMIUM
PRIMARY/SPECIALTY COPAY (In-Network)
INPATIENT HOSPITAL COPAY (In-Network)
PART D PRESCRIPTION BENEFIT
(Tier 1 / 2 / 3 / 4 / 5)
MONTHLY PREMIUM
$0
PRIMARY/SPECIALTY COPAY (In-Network)
$0/$35
INPATIENT HOSPITAL COPAY (In-Network)
Days 1-6: $325 per day. Additional days: $0. Unlimited Days for Medicare covered stays. ($1,950 Annual Member Copay Maximum).
PART D PRESCRIPTION BENEFIT
$450 deductible on tiers 3, 4 & 5 only. $0/$20/$47/50%/27% to out-of-pocket maximum of $2,000.