Access Medicare New York Silver Gold and Platinum Review

Access Medicare is a Medicare Advantage HMO in the state of New York offering Medicare benefits to those living in the Bronx, Queens, or in Manhattan.  They offer access to New York’s top hospitals and doctors and provide many benefits that Medicare alone does not provide.  The plan is doctor-owned so you know that the care you receive will be personalized and focused on the best possible care available.  Access Medicare offers three different Medicare Advantage HMO plans.  The plans are:  Access Medicare Silver, Access Medicare Gold, and Access Medicare Platinum.  This review will focus on the most important highlights of the three plans.  Keep in mind that since these plans are HMO’s that you must choose doctors and facilities that are in the plan’s network.  You will also be required to have referrals for specialists in many cases!

Access Medicare Silver

  • Premium – $39.70
  • Max Out-of-Pocket – $3,400
  • Hospital – $170/Day Days 1-5
  • Doctor’s Visits – $0 for all doctors
  • Outpatient Surgery – 15%
  • X-rays and Labs – $20; $0
  • Diagnostic Tests – $0
  • Prescription Drug Deductible – $320
  • Prescription Drug Co-pay – 25%

Access Medicare Gold

  • Premium – $0
  • Max Out-of-Pocket – $3,400
  • Hospital – $270/Day Days 1-5
  • Doctor’s Visits – Primary = $0; Specialists = $15
  • Outpatient Surgery – $50-$100
  • X-rays and Labs – $20; $0
  • Diagnostic Tests – $0
  • Prescription Drug Deductible – $320
  • Prescription Drug Co-pays – Tier 1 = $0; Tier 2 = $30; Tier 3 = $70; Tier 4 = 30%

Access Medicare Platinum

  • Premium – $39.70
  • Max Out-of-Pocket – $3,400
  • Hospital – $185/Day Days 1-5
  • Doctor’s Visits – $0 for all doctors
  • Outpatient Surgery – 15%
  • X-rays and Labs – $20; $0
  • Diagnostic Tests – $0
  • Prescription Drug Deductible – $0
  • Prescription Drug Co-pay – 25%

Each of these plans carries some type of extra benefits such as dental, vision, and hearing.  The benefits can be impressive depending on which plan you are considering.  For example, the Gold and Platinum plans offer free cleanings and x-rays as well as $1,000 in Comprehensive dental care every year.  The Silver plans offers free eye exams as well as glasses and contact lenses.  All three plans offer round trip transportation as well.  Finally, the Gold and Platinum plans offer Over the Counter benefits of $420 for the Gold and $720 for the Platinum plan annually.  You can see the plan’s complete Summary of Benefits and Evidence of Coverage by visiting their website.  They do not however, offer enrollment capabilities from their website.  You can always enroll at www.medicare.gov.

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