2023 Medicare Advantage Plan Details | ||||||||
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Medicare Plan Name: | Spirit (HMO-POS) | |||||||
Location: | Dane, Wisconsin Click to see other locations | |||||||
Plan ID: | H5211 - 001 - 0 Click to see other plans | |||||||
Member Services: | 1-715-221-9897 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 Spirit (HMO-POS) benefit details | ||||||||
— Medicare Plan Features — | ||||||||
Monthly Premium: | $139.00 (see Plan Premium Details below) | |||||||
Annual Rx Deductible: | no drug coverage | |||||||
Health Plan Type: | Local HMO * | |||||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $1,200 | |||||||
Number of Members enrolled in this plan in Dane, Wisconsin: | 15 members | |||||||
Number of Members enrolled in this plan in Wisconsin: | 2,002 members | |||||||
Number of Members enrolled in this plan in (H5211 - 001): | 2,119 members | |||||||
Plan’s Summary Star Rating: | 4.5 out of 5 Stars. | |||||||
• Customer Service Rating: | 4 out of 5 Stars. | |||||||
• Member Experience Rating: | 4 out of 5 Stars. | |||||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. | |||||||
— Plan Premium Details — | ||||||||
Monthly Premium with Extra Help Low-Income Subsidy (LIS): | data not available |
— Plan Health Benefits — | |||||
** Base Plan ** | |||||
Premium | |||||
• Total monthly premium: $139.00 | |||||
• Health plan premium: $139 | |||||
• Drug plan premium: $0 | |||||
• You must continue to pay your Part B premium. | |||||
• Part B premium reduction: No | |||||
Medically-approved non-opioid pain management services | |||||
• Chiropractic services: Routine care coverage | |||||
• Acupuncture: Not covered | |||||
• Therapeutic Massage: Not covered | |||||
• Alternative Therapies: Not covered | |||||
More benefits | |||||
• Over-the-counter drug benefits: Some coverage | |||||
• Meals for short duration: Not covered | |||||
• Annual physical exams: Some coverage | |||||
• Telehealth: Some coverage | |||||
• WorldWide emergency transportation: Some coverage | |||||
• WorldWide emergency coverage: Some coverage | |||||
• WorldWide emergency urgent care: Some coverage | |||||
• Fitness Benefit: Some coverage | |||||
• In-Home Support Services: Not covered | |||||
• Bathroom Safety Devices: Some coverage | |||||
• Health Education: Some coverage | |||||
• In-Home Safety Assessment: Some coverage | |||||
• Personal Emergency Response System (PERS): Not covered | |||||
• Medical Nutrition Therapy (MNT): Not covered | |||||
• Post discharge In-Home Medication Reconciliation: Not covered | |||||
• Re-admission Prevention: Some coverage | |||||
• Wigs for Hair Loss Related to Chemotherapy: Not covered | |||||
• Weight Management Programs: Not covered | |||||
• Adult Day Health Services: Not covered | |||||
• Nutritional/Dietary Benefit: Not covered | |||||
• Home-Based Palliative Care: Not covered | |||||
• Support for Caregivers of Enrollees: Not covered | |||||
• Additional Sessions of Smoking and Tobacco Cessation Counseling: Some coverage | |||||
• Enhanced Disease Management: Some coverage | |||||
• Telemonitoring Services: Some coverage | |||||
• Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline): Some coverage | |||||
• Counseling Services: Not covered |