AgeRight Advantage Health Plan (HMO I-SNP) members get more than what is covered by Original Medicare, with a dedicated nurse practitioner leading a personalized care plan. AgeRight Advantage is a Special Needs plan that covers all the benefits of Original Medicare (Parts A and B) with prescription drug coverage (Part D). If you or your loved one is eligible, AgeRight Advantage may be the extra benefit you need to maintain and enhance your health and well-being. Some of the benefits include specialized chronic disease care coordination, preventative screenings, and routine vision, hearing and foot care.
- Coordinated care and more personal attention.
- Part D prescription drug coverage.
- Routine vision, hearing and routine foot care, plus dental and other preventive services.
- Regular visits from your Nurse Practitioner to your residing facility to help avoid unnecessary and often unwanted trips to the hospital.
- Nurse Practitioners can complete tests and treatments in the facility that are normally done in the hospital.
- One point of contact for communication with you, your family, your doctors, and the nursing facility staff.
How much is the monthly premium?
$36.00 per month. In addition, you must keep paying your Medicare Part B premium.
How much is the deductible?
$198 per year for in-network services.
$445 deductible per year for Part D prescription drugs.
Is there any limit on how much I will pay for my covered services?
Yes. Like all Medicare health plans, our plan protects you by having yearly limits on your out-of-pocket costs for medical and hospital care.
Your yearly limit(s) in this plan:
- $6,500 for services you receive from in-network providers.
If you reach the limit on out-of-pocket costs, you keep getting covered hospital and medical services and we will pay the full cost for the rest of the year.
Please note that you will still need to pay your monthly premiums and cost-sharing for your Part D prescription drugs.
Is there a limit on how much the plan will pay?
Our plan has a coverage limit every year for certain in-network benefits. Contact us for the services that apply.
|Dental Services||$0 Copay Routine exam, cleaning, and x-rays, and annual allowance of $615 towards comprehensive services|
|Podiatry||$0 Copay for 6 routine foot care visits per year|
|Hearing||$0 Copay for routine hearing exam, hearing aid fitting and evaluation
Plan pays up to $1,600 for hearing aids every two years
|Preventive Care||$0 Copay for many preventive services and screenings, including but not limited to:
Obesity screening and counseling
Vaccines, including Flu shots, Hepatitis B shots, Pneumococcal shots
“Welcome to Medicare” preventive visit (one-time)
Yearly “Wellness” visit
Any additional preventive services approved by Medicare during contract year will be covered
|Primary Care Physician (PCP) Visit||$0 Copay|
|Skilled Nursing||No prior hospitalization required for a skilled nursing stay|
|Vision||$0 Copay for routine eye exam
Plan pays up to $225 for eyewear every year
Full benefits, plan premiums, and cost sharing information for this plan may be found within the Summary of Benefits.
AgeRight Advantage will help make your Medicare benefits work better for you.
The AgeRight Advantage mission statement is to promote the vitality within each of AgeRight Advantage’s clients and staff members. AgeRight Advantage is owned by Marquis Companies that consists of 23 locations supporting Post Acute Care & Rehab / Long Term Care, Assisted Living and Alzheimer’s care and Marquis at Home. AgeRight Advantage’s sister company, Consonus, provides pharmacy, rehabilitation, staffing & consulting to the long-term care community.
Want more information about AgeRight Advantage?
Call us at 1-844-854-6885 or TTY 711.
Our trained member service representatives are available from 8:00 a.m. to 8:00 p.m., or fill out the contact me form to have us call you.