Pay Bill2026 Encompass 65® RED 042 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
$40
PRIMARY/SPECIALTY COPAY (In-Network)
Tier A: $0/$55
Tier B: $20/$55
INPATIENT HOSPITAL COPAY (In-Network)
$300 deductible then
Tier A: Days 1-3: $500 per day. Additional days: $0. Unlimited Days for Medicare covered stays. ($6,171 Annual Member Copay Maximum).
Tier B: Days 1-3: $743 per day. Additional days: $0. Unlimited Days for Medicare covered stays. ($6,171 Annual Member Copay Maximum)
PART D PRESCRIPTION BENEFIT
$250 deductible on tiers 3, 4 & 5 only. $0/$7/16%/37%/30% to out-of-pocket maximum of $2,100.