Medicare Advantage Plan Benefit Details in Plain Text |
The following Medicare Advantage plan benefits apply to the Soundpath Health Sound + Rx (HMO) (H9302 - 007) in Snohomish, Washington State . This plan is administered by SOUNDPATH HEALTH. To switch to a different Medicare Advantage plan or to change your location, click here. |
Click here to see the Soundpath Health Sound + Rx (HMO) health and prescription benefit details in chart format
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Plan Premium |
The Soundpath Health Sound + Rx (HMO) has a monthly premium of $40.00. That is $480.00 for 12 months. There are a few factors that can increase or decrease this premium.
If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher.
Please remember that the $40.00 montly premium is in addition to your Medicare Part B premium. If you have a premium penalty, your premium will be higher. Or if you have a higher income you would be subject to the Income Related Adjustment Amount (IRMAA). |
This Medicare Advantage Plan with Prescription Drug Coverage is a Local HMO plan. |
Plan Membership and Plan Ratings |
The Soundpath Health Sound + Rx (HMO) (H9302 - 007) currently has 6,141 members. . |
The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars. The detail CMS plan carrier ratings are as follows:
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Prescription Drug Coverage: Deductible, Cost-sharing, Formulary |
This plan has a $160 deductible. However, formulary drugs on Tier 1 and 2 are excluded from the $160 deductible and have first dollar coverage (or a $0 deductible). So, you are 100% responsible for the first $160 in medication costs for drugs not on the excluded tiers. After you have met the deductible, the Soundpath Health Sound + Rx (HMO) will share the costs of your medications with you (see cost-sharing below). The maximum deductible for 2018 is $405, but this plan (Soundpath Health Sound + Rx (HMO)) has a $160. There are other plans with a lower deductible or even a $0 deductible for all formulary drugs. Click here to review plans with a $0 deductible. |
The following information is about the Soundpath Health Sound + Rx (HMO) formulary (or drug list). There are 4258 drugs on the Soundpath Health Sound + Rx (HMO) formulary. Click here to browse the Soundpath Health Sound + Rx (HMO) Formulary. |
The Initial Coverage Phase (ICP) can be thought of as the cost-sharing phase of the plan. During this phase, you and the insurance company share your prescription costs. Once you have spent $160, your initial coverage phase will start. All medication are divided into tiers within the plans formulary. This helps the plan to organize and manage the prescription cost-sharing. The Soundpath Health Sound + Rx (HMO)’s formulary is divided into 5 tiers. Every plan can name their tiers differently, and can place medications on any tier. The cost-sharing for this plan is divided as follows:
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The Coverage Gap, which is also known as the Donut (Doughnut) Hole is the phase of your Medicare Part D plan where
you are responsible for 100% of your medication costs. Healthcare Reform mandates that the insurance carrier pay 56% of your generic drug prescription costs in the donut hole on your behalf. The brand-name drug manufacturer will pay 50% and your plan will pay an additional 15% of the cost of your brand-name drugs purchased in the Donut Hole, for a total of 65% discount. The 50% paid by the brand-name drug manufacturer is paid on your behalf and therefore counts toward your TrOOP (or True Out-of-Pocket) costs. The portion paid by your plan, does not count toward TrOOP. Some Medicare Part D plans offer coverage during the Coverage Gap that is beyond the mandated discounts. Any drug not covered by the plan’s Gap Coverage will still receive the discounts noted above -- even if the plan has "No Gap Coverage". This plan (Soundpath Health Sound + Rx (HMO)) offers No Coverage during the Coverage Gap phase. |
The Soundpath Health Sound + Rx (HMO) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail. |