2019 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | Allwell Dual Medicare (HMO SNP) | ||||
Location: | Santa Cruz, Arizona Click to see other locations | ||||
Plan ID: | H5590 - 006 - 0 Click to see other plans | ||||
Member Services: | |||||
— 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 Allwell Dual Medicare (HMO SNP) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $0.00 for people who qualify for both Medicare and Medicaid. | ||||
Annual Deductible: | $0 for people who qualify for both Medicare and Medicaid. | ||||
Annual Initial Coverage Limit (ICL): | $3,820 | ||||
Health Plan Type: | Local HMO | ||||
Special Needs Plan (SNP) Eligibility Requirement: | Dual-Eligible | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 3,474 drugs | Browse the Allwell Dual Medicare (HMO SNP) Formulary | |||
This plan has 6 drug tiers. See cost-sharing for all pharmacies and tiers. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $0.00 | $20.00 | $47.00 | $100.00 | 29% |
• Number of Drugs per Tier: | 268 | 757 | 817 | 815 | 676 |
Plan Offers Mail Order? | Yes | ||||
Number of Members enrolled in this plan in Santa Cruz, Arizona: | 368 members | ||||
Number of Members enrolled in this plan in (H5590 - 006): | 6,063 members | ||||
Plan’s Summary Star Rating: | 3.5 out of 5 Stars. | ||||
• Customer Service Rating: | 4 out of 5 Stars. | ||||
• Member Experience Rating: | Insufficient data to rate this plan. | ||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. |
— Plan Health Benefits — |