2017 Medicare Advantage Plan Details | |||||
---|---|---|---|---|---|
Medicare Plan Name: | Tufts Medicare Preferred HMO Value No Rx (HMO) | ||||
Location: | Norfolk, Massachusetts Click to see other locations | ||||
Plan ID: | H2256 - 019 - 7 Click to see other plans | ||||
Member Services: | 1-800-701-9000 TTY users 1-800-208-9562 | ||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
||||
Email a copy of the Tufts Medicare Preferred HMO Value No Rx (HMO) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $97.00 (see Plan Premium Details below) | ||||
Annual Rx Deductible: | no drug coverage | ||||
Health Plan Type: | Local HMO * | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $3,400 | ||||
Number of Members enrolled in this plan in Norfolk, Massachusetts: | 50 members | ||||
Number of Members enrolled in this plan in Massachusetts: | 134 members | ||||
Number of Members enrolled in this plan in (H2256 - 019): | 366 members | ||||
Plan’s Summary Star Rating: | 5 out of 5 Stars. This plan qualifies for the 5-star rating Special Enrollment period. Read more. | ||||
• Customer Service Rating: | 4 out of 5 Stars. | ||||
• Member Experience Rating: | 4 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. | ||||
— Plan Premium Details — | |||||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ | 100% Subsidy | 75% Subsidy | 50% Subsidy | 25% Subsidy | |
Monthly Part D Premium with LIS: | $0.00 | $0.00 | $0.00 | $0.00 | |
— Plan Health Benefits — | |||||
** General Plan Information ** | |||||
Choice of Doctors?: Plan Doctors for Most Services | |||||
** Cost ** | |||||
Monthly Health Plan Premium: $97.00 | |||||
Monthly Drug Plan Premium: Not Applicable | |||||
Health Plan Deductible: $0 | |||||
Other Health Plan Deductibles?: No | |||||
Maximum Out-of-Pocket Enrollee Responsibility (does not include prescription drugs) : $3,400 In-network | |||||
** Extra Benefits ** | |||||
Prescription Drugs Covered?: No | |||||
Optional Supplemental Benefits?: Yes | |||||
** Outpatient Care and Services ** | |||||
Ambulance: $200 | |||||
Doctor's office visits:
| |||||
Durable medical equipment (wheelchairs, oxygen, etc.): 10% per item | |||||
Emergency care: $75 per visit (always covered) | |||||
Home health care: $0-20 | |||||
Mental health care:
| |||||
Outpatient hospital: $150 per visit | |||||
Renal dialysis: You pay nothing | |||||
** Inpatient Care ** | |||||
Inpatient hospital care:
| |||||
Optional Supplemental Benefits?: Yes | |||||
Skilled Nursing Facility (SNF):
| |||||
Prescription Drugs Covered?: No | |||||
** Additional Benefits ** | |||||
Optional Supplemental Benefits?: Yes |