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Text Size Up
Text Size DownComparison of 2010 Medicare Plans
WHP Silver (HMO)
|
WHP Silver Rx (HMO)
|
WHP Platinum Rx (HMO)
|
Platinum Select Rx (HMO-POS)
|
|
| Monthly Premium | $0 |
$60 |
$95 |
$150 Access to certain benefits out of the network. |
| Annual Deductible | $0 |
$0 |
$0 |
$0 |
| PCP Office Visit | $20 |
$20 |
$15 |
$15 |
| Specialist Office Visit | $35 |
$35 |
$25 |
$25 |
| Inpatient Hospital Care | Days 1-5: $150/day Days 6-10: $80/day Days 11+: $0/day |
Days 1-5: $150/day Days 6-10: $80/day Days 11+: $0/day |
$400/hospital stay |
$400/hospital stay |
| Emergency Room Visit - Not Admitted | $50 Worldwide |
$50 Worldwide |
$50 Worldwide |
$50 Worldwide |
| Drug Coverage (Generic) |
No coverage |
$8 copay for |
$4 copay for |
$4 copay for |
| Drug Coverage (Brand) |
No coverage |
$39 copay for |
$30 copay for |
$30 copay for |
| Dental | $0 copay for Preventive Dental |
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| Hearing | Yes |
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| Vision | Yes |
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| Personalized Fitness Program | Yes |
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A Federally-Qualified HMO with a Medicare contract. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan.
Individuals must have both Part A and Part B to enroll. You must continue to pay your Medicare Part B premium even if the plan premium is $0. Members may enroll in the plan only during specific times of the year. Contact Welborn Health Plans for more information.
Beneficiaries must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply. HMO members must receive all routine care from plan providers. Plans may be renewed annually. Limitations, copayments, and restrictions may apply.
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If eligible, Medicare could pay for up to one hundred (100) percent of drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.
Updated 7/2010
H3044_H1558_WHPWeb (10/2009)
