Medicare Advantage Plan Benefit Details in Plain Text |
The following Medicare Advantage plan benefits apply to the EON SELECT (HMO) (H6672 - 004) in Walton, Georgia . This plan is administered by EON HEALTH, INC. (GA). To switch to a different Medicare Advantage plan or to change your location, click here. |
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Plan Premium |
This plan has a $0.00 monthly premium. Although you pay no additional monthly premium, you must continue to pay 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 |
The EON SELECT (HMO) (H6672 - 004) currently has 252 members. There are less than 10 members enrolled in this plan in Walton, Georgia, and 29 members in Georgia. |
Prescription Drug Coverage: Deductible, Cost-sharing, Formulary |
This plan has a $250 deductible. However, formulary drugs on Tier 1 and 2 are excluded from the $250 deductible and have first dollar coverage (or a $0 deductible). So, you are 100% responsible for the first $250 in medication costs for drugs not on the excluded tiers. After you have met the deductible, the EON SELECT (HMO) will share the costs of your medications with you (see cost-sharing below). The maximum deductible for 2018 is $405, but this plan (EON SELECT (HMO)) has a $250. 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 EON SELECT (HMO) formulary (or drug list). There are 4258 drugs on the EON SELECT (HMO) formulary. Click here to browse the EON SELECT (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 $250, 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 EON SELECT (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 (EON SELECT (HMO)) offers No Coverage during the Coverage Gap phase. |
The EON SELECT (HMO) offers many Health and Prescription Drug Coverage Benefits. The following section will describe these benefits in detail. |