2017 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | Secure Saver (MSA) | ||||
Location: | Douglas, Wisconsin Click to see other locations | ||||
Plan ID: | H4388 - 001 - 0 Click to see other plans | ||||
Member Services: | 1-877-998-0998 TTY users 711 | ||||
— 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 |
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Email a copy of the Secure Saver (MSA) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | MSAs do not have a monthly premium. (see Plan Premium Details below) | ||||
Annual Deductible: | no drug coverage | ||||
Health Plan Type: | MSA * | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $0 | ||||
Number of Members enrolled in this plan in Douglas, Wisconsin: | 46 members | ||||
Number of Members enrolled in this plan in Wisconsin: | 1,483 members | ||||
Number of Members enrolled in this plan in (H4388 - 001): | 3,520 members | ||||
Plan’s Summary Star Rating: | Not Applicable. | ||||
• Customer Service Rating: | Plan not required to report measure. | ||||
• Member Experience Rating: | Plan not required to report measure. | ||||
• Drug Cost Accuracy Rating: | Plan not required to report measure. | ||||
— 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?: Any Doctor | |||||
** Cost ** | |||||
Monthly Health Plan Premium: $0.00 | |||||
Monthly Drug Plan Premium: Not Applicable | |||||
Health Plan Deductible: $4,500 annual deductible | |||||
Other Health Plan Deductibles?: No | |||||
Maximum Out-of-Pocket Enrollee Responsibility (does not include prescription drugs) : Not Applicable | |||||
** Extra Benefits ** | |||||
Prescription Drugs Covered?: No | |||||
Optional Supplemental Benefits?: No | |||||
** Outpatient Care and Services ** | |||||
Ambulance: Not Applicable | |||||
Doctor's office visits:
| |||||
Durable medical equipment (wheelchairs, oxygen, etc.): Not Applicable | |||||
Emergency care: Not Applicable | |||||
Home health care: Not Applicable | |||||
Mental health care: Not Applicable | |||||
Outpatient hospital: Not Applicable | |||||
Renal dialysis: Not Applicable | |||||
** Inpatient Care ** | |||||
Inpatient hospital care: Not Applicable | |||||
Optional Supplemental Benefits?: No | |||||
Skilled Nursing Facility (SNF): Not Applicable | |||||
Prescription Drugs Covered?: No | |||||
** Additional Benefits ** | |||||
Optional Supplemental Benefits?: No |