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2019 Medicare Advantage Plan Benefit Details for the AARP MedicareComplete Plan 2 (HMO) - H5253-038-0
This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

2019 Medicare Advantage Plan Details
Medicare Plan Name:AARP MedicareComplete Plan 2 (HMO)
Location:Person, North Carolina     Click to see other locations
Plan ID:H5253 - 038 - 0     Click to see other plans
Member Services:1-800-643-4845 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
Email a copy of the AARP MedicareComplete Plan 2 (HMO) benefit details
— Medicare Plan Features —
Monthly Premium:$0.00 (see Plan Premium Details below)
Annual Deductible:$95 (Tier 1, 2, and 3 excluded from the Deductible.)
Annual Initial Coverage Limit (ICL):$3,820
Health Plan Type:Local HMO
Maximum Out-of-Pocket Limit for Parts A & B (MOOP):$6,700
Additional Gap Coverage?No additional gap coverage, only the Donut Hole Discount
Total Number of Formulary Drugs:3,677 drugsBrowse the AARP MedicareComplete Plan 2 (HMO) Formulary
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. 
Formulary Drug Details:Tier 1Tier 2Tier 3Tier 4Tier 5
• Preferred Pharmacy
  Cost-Sharing during
  initial coverage phase:		$2.00$8.00$45.00$95.0031%
• Number of Drugs per
  Tier:		3006538691074781
Plan's Pharmacy Search:http://www.AARPMedicarePlans.com
Plan Offers Mail Order?Yes
Number of Members enrolled in this plan in Person, North Carolina:131 members
Number of Members enrolled in this plan in North Carolina:35,368 members
Number of Members enrolled in this plan in (H5253 - 038):35,473 members
Plan’s Summary Star Rating: 4 out of 5 Stars.
• Customer Service Rating: 5 out of 5 Stars.
• Member Experience Rating: 4 out of 5 Stars.
• Drug Cost Accuracy Rating: 4 out of 5 Stars.
— Plan Premium Details —
The Monthly Premium is Split as Follows: ❔
Total
Premium		Part C
Premium		Part D Base
Premium		Part D Supplemental
Premium
$0.00$0.00$0.00$0.00
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
Total Monthly Premium with LIS (Parts C & D):$0.00$0.00$0.00$0.00
— Plan Health Benefits —
** Benefit Highlights **
Health plan deductible
• $0
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
• $6,700 In-network
Optional supplemental benefits
• Yes
Inpatient hospital coverage
• $430 per day for days 1 through 4
$0 per day for days 5 through 90
$0 per day for days 91 and beyond
Outpatient hospital coverage
• $395 per visit
Preventive care
• $0 copay
Other health plan deductibles?
• In-Network:  No
Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?
• In-Network:  No
Doctor visits
• Primary:  $0-20 per visit
• Specialist:  $35-50 per visit
Emergency care/Urgent care
• Emergency:  $90 per visit (always covered)
• Urgent care:  $30-40 per visit (always covered)
Skilled Nursing Facility
• $0 per day for days 1 through 20
$160 per day for days 21 through 62
$0 per day for days 63 through 100
Ground ambulance
• $250
Transportation
• $0 copay
Wellness programs (e.g., fitness, nursing hotline)
• Covered
Vision
• Routine eye exam:  $0 copay
• Other:  Not covered
• Contact lenses:  Not covered
• Eyeglasses (frames and lenses):  Not covered
• Eyeglass frames:  Not covered
• Eyeglass lenses:  Not covered
• Upgrades:  Not covered
Mental health services
• Inpatient hospital - psychiatric:  $430 per day for days 1 through 3
$0 per day for days 4 through 90
• Outpatient group therapy visit with a psychiatrist:  $30
• Outpatient individual therapy visit with a psychiatrist:  $40
• Outpatient group therapy visit:  $30
• Outpatient individual therapy visit:  $40
Rehabilitation services
• Occupational therapy visit:  $40
• Physical therapy and speech and language therapy visit:  $40
Foot care (podiatry services)
• Foot exams and treatment:  $50
• Routine foot care:  $50
Medical equipment/supplies
• Durable medical equipment (e.g., wheelchairs, oxygen):  20% per item
• Prosthetics (e.g., braces, artificial limbs):  20% per item
• Diabetes supplies:  $0 per item
Medicare Part B drugs
• Chemotherapy:  20%
• Other Part B drugs:  20%
** Benefits Services **
Diagnostic procedures/lab services/imaging
• Diagnostic tests and procedures:  20%
• Lab services:  $2
• Diagnostic radiology services (e.g., MRI):  20%
• Outpatient x-rays:  $14
Hearing
• Hearing exam:  $20
• Fitting/evaluation:  Not covered
• Hearing aids:  $300-2,025
Preventive dental
• Oral exam:  Not covered
• Cleaning:  Not covered
• Fluoride treatment:  Not covered
• Dental x-ray(s):  Not covered
Comprehensive dental
• Non-routine services:  Not covered
• Diagnostic services:  Not covered
• Restorative services:  Not covered
• Endodontics:  Not covered
• Periodontics:  Not covered
• Extractions:  Not covered
• Prosthodontics, other oral/maxillofacial surgery, other services:  Not covered
** Optional Supplemental Benefits **
Package #1
• Comprehensive dental, Preventive dental
• Monthly Premium:  $39.00
• Deductible:  $100.00




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