h5521 summary of benefitsh5521 summary of benefits

Not a member yet? You can find more details on each benefit listed below in the Evidence of Coverage (EOC). WebGet 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Limitations, copayments, and restrictions may apply. Need a complete list of what we cover and any limitations? Summary of Benefits 2023 Summary of Benefits - SunFireMatrix The benefit information provided is a brief summary, not a complete description of benefits. Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. The benefit information provided is a brief summary, not a complete description of benefits. Aetna Medicare Freedom Plan (PPO) H5521-216 Plan Details. For more information contact the plan. You can use in-network and out-of-network providers. Aetna Medicare Premier Plan (PPO) is a PPO H5521-214 Primary benefits Your costs for innetwork care Your costs for outofnetwork care (in addition to Original Medicare coverage) prescription eyewear. Keep in mind: This is just a summary. It does not list every service or every limitation and exclusion. WebSummary of Benefits 2021 Aetna Medicare Premier Plus Plan (PPO) H5521 - 170 January 1, 2021 - December 31, 2021 0 1_A Call us or go online for more information. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). C. Summary of Costs, Transfers, and Benefits TABLE A1: SUMMARY OF You can use in-network and out-of-network providers. | Summary of Benefits WebSummary of Benefits 2021 Aetna Medicare Premier Plan (PPO) H5521 - 081 January 1, This is a Medicare Advantage plan that covers prescription drugs. WebNumber of Members enrolled in this plan in (H5521 - 293): 7,803 members : Plans Summary Star Rating: 4.5 out of 5 Stars. The benefit information provided is a summary of what we cover and what you pay. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. (b) The plans for titles IV-E and IV-B must provide for compliance with the Department's regulations applicable to the State and/or Tribe as listed in 45 CFR 1355.30. Star Ratings are calculated each year and may change from one year to the next. Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. H5521-086 | $0 Other benefits Your costs for in-network care Your costs for out-of-network care Equipment, prosthetics, & supplies* Diabetic supplies 0% - 20% 0% - 20% However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Learn Aetna Medicare Freedom Plan (PPO You can use in-network and out-of-network providers. Summary of Benefits Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. 0% - 20% Higher cost-share applies to non-OneTouch/LifeScan diabetic supplies. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Summary of Benefits The EOC is available atAetnaMedicare.com or you may call us to request a copy. | We do not sell leads or share your personal information. WebPlan ID: H5521-216. Mental health services* Inpatient psychiatric stay $280 per day, days 16; $0 per WebPlan ID: H5521-082. services or drugs. gcse.type = 'text/javascript'; (H5521 - 348): 2,486 members : Plans Summary Star Rating: 4.5 'https:' : 'http:') + Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. Just visit Other health plan deductibles: In-network: No, Drug plan deductible: No annual deductible, Primary Out-of-network: 50% coinsurance per visit, Specialist In-network: $40 copay per visit, Specialist Out-of-network: 50% coinsurance per visit, Diagnostic tests and procedures In-network: $0-95 copay (authorization required), Diagnostic tests and procedures Out-of-network: 50% coinsurance (authorization required), Lab services In-network: $0 copay (authorization required), Lab services Out-of-network: 50% coinsurance (authorization required), Outpatient x-rays In-network: $0-50 copay (authorization required), Outpatient x-rays Out-of-network: 50% coinsurance (authorization required), Emergency: $90 copay per visit (always covered), Urgent care: $0-65 copay per visit (always covered), In-network: $300 per day for days 1 through 7, Out-of-network: 50% per stay (authorization required), In-network: $0-275 copay per visit (authorization required), Out-of-network: 50% coinsurance per visit (authorization required), In-network: $0 per day for days 1 through 20, Occupational therapy visit In-network: $40 copay (authorization required), Occupational therapy visit Out-of-network: 50% coinsurance (authorization required), Physical therapy and speech and language therapy visit In-network: $40 copay (authorization required), Physical therapy and speech and language therapy visit Out-of-network: 50% coinsurance (authorization required), Inpatient hospital - psychiatric In-network: $318 per day for days 1 through 5, Inpatient hospital - psychiatric Out-of-network: 50% per stay (authorization required), Outpatient group therapy visit with a psychiatrist In-network: $40 copay (authorization required), Outpatient group therapy visit with a psychiatrist Out-of-network: 50% coinsurance (authorization required), Outpatient individual therapy visit with a psychiatrist In-network: $40 copay (authorization required), Outpatient individual therapy visit with a psychiatrist Out-of-network: 50% coinsurance (authorization required), Outpatient group therapy visit In-network: $40 copay (authorization required), Outpatient group therapy visit Out-of-network: 50% coinsurance (authorization required), Outpatient individual therapy visit In-network: $40 copay (authorization required), Outpatient individual therapy visit Out-of-network: 50% coinsurance (authorization required), In-network: $40.00 copay (authorization required), Out-of-network: 50% coinsurance (authorization required), Diabetes supplies In-network: 0-20% coinsurance per item (authorization required), Diabetes supplies Out-of-network: 0-20% coinsurance per item (authorization required), 20% coinsurance (authorization required), Hearing exam Out-of-network: 50% coinsurance, Fitting/evaluation In-network: $0 copay (limits apply), Fitting/evaluation Out-of-network: 50% coinsurance (limits apply), Hearing aids In-network: $0 copay (limits apply), Hearing aids Out-of-network: $0 copay (limits apply), Oral exam In-network: $0 copay (limits apply), Oral exam Out-of-network: 20% coinsurance (limits apply), Cleaning In-network: $0 copay (limits apply), Cleaning Out-of-network: 20% coinsurance (limits apply), Fluoride treatment In-network: $0 copay (limits apply), Fluoride treatment Out-of-network: 20% coinsurance (limits apply), Dental x-ray(s) In-network: $0 copay (limits apply), Dental x-ray(s) Out-of-network: 20% coinsurance (limits apply), Non-routine services In-network: $0 copay (limits apply, authorization required), Non-routine services Out-of-network: 20% coinsurance (limits apply, authorization required), Diagnostic services In-network: $0 copay (limits apply, authorization required), Diagnostic services Out-of-network: 20% coinsurance (limits apply, authorization required), Restorative services In-network: $0 copay (limits apply, authorization required), Restorative services Out-of-network: 20% coinsurance (limits apply, authorization required), Endodontics In-network: $0 copay (limits apply, authorization required), Endodontics Out-of-network: 20% coinsurance (limits apply, authorization required), Periodontics In-network: $0 copay (limits apply, authorization required), Periodontics Out-of-network: 20% coinsurance (limits apply, authorization required), Extractions In-network: $0 copay (limits apply, authorization required), Extractions Out-of-network: 20% coinsurance (limits apply, authorization required), Prosthodontics, other oral/maxillofacial surgery, other services In-network: $0 copay (limits apply, authorization required), Prosthodontics, other oral/maxillofacial surgery, other services Out-of-network: 20% coinsurance (limits apply, authorization required), Routine eye exam In-network: $0 copay (limits apply), Routine eye exam Out-of-network: 50% coinsurance (limits apply), Contact lenses In-network: $0 copay (limits apply), Contact lenses Out-of-network: $0 copay (limits apply), Eyeglasses (frames and lenses) In-network: $0 copay (limits apply), Eyeglasses (frames and lenses) Out-of-network: $0 copay (limits apply), Eyeglass frames In-network: $0 copay (limits apply), Eyeglass frames Out-of-network: $0 copay (limits apply), Eyeglass lenses In-network: $0 copay (limits apply), Eyeglass lenses Out-of-network: $0 copay (limits apply), Upgrades In-network: $0 copay (limits apply), Upgrades Out-of-network: $0 copay (limits apply), Over-the-counter drug benefits: Some coverage, Meals for short duration: Some coverage, WorldWide emergency transportation: Some coverage, WorldWide emergency coverage: Some coverage, WorldWide emergency urgent care: Some coverage. Providers who do not contract with the plan are not required to see you except in an emergency. 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. WebAetna Medicare Eagle Plan (PPO) | H5521-235 | $0 Primary benefits Your costs for in-network care Your costs for out-of-network care Outpatient hospital $30 - $195 35% services Lower cost sharing applies for services other than surgery. WebGet 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Aetna Medicare Premier Plan (PPO) covers a range of additional benefits. You can use in-network and out-of-network providers. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. $ 77.00 Monthly Premium Virginia Counties Served Amelia Chesterfield Augusta Caroline Charles City Colonial Heights City Cumberland Dinwiddie Goochland Hanover Henrico Hopewell City King William New Kent Nottoway Petersburg City Powhatan Prince George Richmond City Staunton City Waynesboro City Basic Costs and Coverage WebSummary of Benefits 2021 Aetna Medicare Premier Plan (PPO) H5521 - 081 January 1, 2021 - December 31, 2021 H5521-081 1_A Call us or go online for more information. You are responsible for any costs over this amount. Mentions lgales WebThis is a Medicare Advantage plan that covers prescription drugs. H5521 services or drugs. Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. (function() { Summary of Benefits Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. (c) The State agency and s.parentNode.insertBefore(gcse, s); Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Those who disenroll services or drugs. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. WebAetna Medicare Prime Credit (PPO) | H5521-277 | $0 Aetna Medicare Prime Credit (PPO) is a PPO plan. Call 1-833-859-6031 (TTY: 711) October 1 to March 31: 7 days a week from 8 AM to 8 PM local time April 1 to September 30: Monday - Friday from 8 AM to 8 PM local time Please see. 2023 Summary of Benefits - SunFireMatrix Rseau Summary of Benefits Out-of-Network: 50% per stay. In-Network: $395 per day for days 1 through 4 / $0 per day for days 5 through 90. You can find more details on each benefit listed below in the Evidence of Coverage (EOC). Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. WebSummary of Benefits 2021 Aetna Medicare Premier Plus (PPO) H5521 - 273 January 1, 2021 - December 31, 2021 3 1_A Call us or go online for more information. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). (b) The plans for titles IVE and IVB must provide for compliance with the Department's regulations applicable to the State and/or Tribe as listed in 45 CFR 1355.30. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; You can use in-network and out-of-network providers. var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Not a member yet? Infos Utiles WebThe benefit information provided is a summary of what we cover and what you pay. DEPARTMENT OF HEALTH AND HUMAN SERVICES Orthotics Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. 2023-H5521.281.1 H5521-281 Aetna Medicare Value Plan (PPO) H5521 281 Heres a summary of the services we cover from January 1, 2023 through December 31, 2023. WebSummary of Benefits 2022 Aetna Medicare Elite Plan (PPO) H5521 - 120 January 1, 2022 - December 31, 2022 H5521-120 1 Call us or go online for more information. 2023-H5521.169.1 H5521-169 Aetna Medicare Value Plan (PPO) H5521 169 Heres a summary of the services we cover from January 1, 2023 through December 31, 2023. This is a Medicare Advantage plan that covers prescription drugs. You can find more details on each benefit listed below in the Evidence of Coverage (EOC). WebInpatient hospital - psychiatric. Just visit Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. Summary of Benefits Remember to write the during the calendar year will owe a portion of the account deposit back to the plan. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. (c) The State agency and the Indian Tribe must make available for public review and inspection the Child and Family Services Plan (CFSP) and the Annual Progress and Services Reports. We are not compensated for Medicare plan enrollments. Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. WebSummary of Benefits 2021 Aetna Medicare Premier Plus (PPO) H5521 - 270 January 1, 2021 - December 31, 2021 0 1_A Call us or go online for more information. The benefit information provided is a summary of what we cover and what you pay. WebThe benefit information provided is a summary of what we cover and what you pay. This plan has a $35 Part B monthly premium rebate (or giveback). area. Need a complete list of what we cover and any limitations? Limitations and exclusions may apply. For more information contact the plan. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. U4PPP Lieu dit "Rotstuden" 67320 WEYER Tl. Plan requirements for titles IV WebAetna Medicare Value Plan (PPO) | H5521-089 | $0 Aetna Medicare Value Plan (PPO) is a PPO plan. Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). You can find more details on each benefit listed below in the Evidence of Coverage (EOC). It does not list every service or every limitation and exclusion. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. gcse.async = true; For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), This information will help us decide if you should get or keep getting benefits. Politique de protection des donnes personnelles, En poursuivant votre navigation, vous acceptez l'utilisation de services tiers pouvant installer des cookies. area. '//cse.google.com/cse.js?cx=' + cx; Just visit H5521-219 | $0 Other benefits Your costs for in-network care Your costs for out-of-network care Equipment, prosthetics, & supplies* Diabetic supplies 0% - 20% 0% - 20% WebMedicare Advantage Plan Benefit Details in Plain Text: The following Medicare Advantage plan benefits apply to the Aetna Medicare Premier Plan (PPO) (H5521 - 081) in Stokes, has given this plan carrier a summary rating of 4.5 stars. services or drugs. Prsentation Summary of Benefits WebSummary of Benefits 2021 Aetna Medicare Premier Plan (PPO) H5521 - 040 January 1, 2021 - December 31, 2021 H5521-040 1_A Call us or go online for more information. You can find more details on each benefit listed below in the Evidence of Coverage (EOC). The plan deposits Personal Emergency Response System (PERS): Post discharge In-Home Medication Reconciliation: Wigs for Hair Loss Related to Chemotherapy: Additional Sessions of Smoking and Tobacco Cessation Counseling: Some coverage, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline): Some coverage, Foot exams and treatment In-network: $45 copay, Foot exams and treatment Out-of-network: $60 copay, Chemotherapy In-network: 20% coinsurance (authorization required), Chemotherapy Out-of-network: 50% coinsurance (authorization required), Other Part B drugs In-network: 20% coinsurance (authorization required), Other Part B drugs Out-of-network: 50% coinsurance (authorization required). WebSummary of Benefits 2022 Aetna Medicare Value (PPO) H5521 - 086 January 1, 2022 - December 31, 2022 H5521-086 1 Call us or go online for more information. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Medicare evaluates plans based on a 5-Star rating system. Summary of Benefits The detail CMS plan carrier ratings are as follows: Customer Service Rating of 5 out of 5 stars; Summary of Benefits - Ribbon Health Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. Aetna Medicare Essential Plan (PPO WebThis is a Medicare Advantage plan that covers prescription drugs. WebThe benefit information provided is a summary of what we cover and what you pay. Medicare evaluates plans based on a 5-Star rating system. WebSelect a Medicare Advantage Plan below to view details about the coverage it provides: Plan Summary of Benefits Summary of Benefits This is a Medicare Advantage plan that covers prescription drugs. '//cse.google.com/cse.js?cx=' + cx; Call 1-833-859-6031 (TTY: 711) October 1 to March 31: 7 days a week from 8 AM to 8 PM local time April 1 to September 30: Monday - Friday from 8 AM to 8 PM local time Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. The benefit information provided is a summary of what we cover and what you pay. Alight Retiree Health Solutions represents Medicare plans from 58 insurers nationwide. Summary of Benefits Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), WebAetna Medicare Premier Plan (PPO) covers a range of additional benefits. Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. Summary of Benefits Our. You are responsible for any costs over this amount. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. It does Electronic Code of Federal Regulations (e-CFR), Subtitle BRegulations Relating to Public Welfare, CHAPTER XIIIADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES, SUBCHAPTER GTHE ADMINISTRATION ON CHILDREN, YOUTH AND FAMILIES, FOSTER CARE MAINTENANCE PAYMENTS, ADOPTION ASSISTANCE, AND CHILD AND FAMILY SERVICES. Ralisations Aetna Medicare Essential Plan (PPO WebSummary of Benefits 2022 Aetna Medicare Premier Plus Plan (PPO) H5521 - 170 January 1, 2022 - December 31, 2022 0 1 Call us or go online for more information. 'https:' : 'http:') + Pourquoi choisir une piscine en polyester ? Web(2) The amount under this paragraph for an annuitant is an amount equal to the old-age Not a member yet? (See 45 CFR 1357.15 and 1357.16.) Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Web(a) The plans for titles IV-E and IV-B must provide for safeguards on the use and For any question below, if you need more space, use item 9, on pages 5 and 6. area. Service area: North Carolina: Summary of Benefits 2021 Summary of Benefits - NC DOI Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), Medicare has neither reviewed nor endorsed the information on our site. Contact the Medicare plan for more information. Providers who do not contract with the plan are not required to see you except in an emergency. 2023-H5521.347.1 H5521-347 Aetna Medicare Eagle (PPO) H5521 347 Heres a summary of the services we cover from January 1, 2023 through December 31, 2023. H5521-326 Primary benefits Your costs for innetwork care Your costs for outofnetwork care EyeMed will manage your eyewear benefits. WebPlan ID: H5521-247. Plan costs & information Innetwork Outofnetwork Monthly plan premium $0 You must continue to pay your Medicare Part B premium. 2023-H5521.347.1 H5521-347 Aetna Medicare Eagle (PPO) H5521 347 WebY0001_H5521_285_PC36_SB22_M Aetna Medicare Value (PPO) is a PPO plan. Keep in mind: This is just a summary. Mental health services* Inpatient psychiatric stay $300 per day, days 17; $0 per Benefits that may require a prior authorization are listed with an asterisk (*) in the benefits grid. WebSummary of Benefits 2022 Aetna Medicare Prime (PPO) H5521 - 207 January 1, 2022 - December 31, 2022 7 1 Call us or go online for more information. MA-Compare: Review Changes in each 2021 Medicare Advantage Plan for 2022, Find a 2022 Medicare Part D Plan (PDP-Finder: Rx Only), Find a 2022 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2022 Medicare Plan Formulary (Drug List), Q1Rx 2022 Medicare Part D or Medicare Advantage Plan Finder by Drug, Guided Help Finding a 2022 Medicare Prescription Drug Plan, Search for 2022 Medicare Plans by Plan ID, Search for 2022 Medicare Plans by Formulary ID, 2022 Medicare Prescription Drug Plan (PDP) Benefit Details, Pre-2020 Medicare.gov Plan Finder Tutorial, Click here to see plans for the current plan year, or contact your local SHIP for assistance, See cost-sharing for all pharmacies and tiers, Learn more about savings on Pet Medications. Summary of Benefits Members may enroll in a Medicare Advantage plan only during specific times of the year. The plan deposits 1-833-859-6031 (TTY: 711) October 1 to March 31: 7 days a week from 8 a.m. - 8 p.m. local time April 1 to September 30: Monday - Friday from 8 a.m. - 8 p.m. local time www.aetnamedicare.com For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. 1-833-859-6031 (TTY: 711) October 1 to March 31: 7 days a week from 8 a.m. - 8 p.m. local time April 1 to September 30: Monday - Friday from 8 a.m. - 8 p.m. local time www.aetnamedicare.com Members may enroll in a Medicare Advantage plan only during specific times of the year.