|Part D Benefit:||Yes|
|Rx Gap Coverage:||Y|
SeniorCare Preferred - Enhanced Rx is a Medicare Cost Contract Medicare Advantage plan, by Insurance Company of Scott & White, available in Coke County, Texas. It offers the complete Medicare benefit package. Payment is based on the reasonable cost of providing services. Beneficiaries are not restricted to the HMO or CMP to receive approved Medicare services.
The monthly premium for this plan in Coke County, TX is $213.20. This amount is paid directly to Insurance Company of Scott & White.
If you enroll in this plan you will pay your Medicare Part B premium plus this plan's monthly premium. Most people pay the standard Part B premium, but some beneficiaries pay higher Part B premiums due to their annual income (over $85k for singles or $170k for married couples). Late enrollment penalties can also increase your Part B premium.
In addition to the premiums you also pay your share when you use healthcare services. Each time you see your doctor, or if you are admitted as an inpatient (hospitalized), you'll pay copayments. Your prescription drugs also have a cost sharing component.
Maximum Out-of-Pocket Limit
2018 Medicare Advantage plans have an annual maximum out-of-pocket (MOOP) limit that protects you from financial disaster. The MOOP limit is $6,700, but plans can go as low as $3,400.
The most you will pay out-of-pocket if you enroll in this plan is $3,400. This amount does not include your monthly premium or the copayments. This is only the amount that you pay out of pocket.
Don't forget to look at the co-payments and co-insurance with Original Medicare (no out-of-pocket limits). If you stay on Original Medicare you'll need a Medicare Supplement to pay the gaps or pay it yourself.
Coverage, Copayments & Coinsurance
The SeniorCare Preferred - Enhanced Rx plan offers the same basic benefits as Original Medicare. The big difference is copayments and coinsurances. Below you will find (where available) what you will pay for common health care services.
Most plans have copayments when you see your primary care doctor or a specialist. Here's how this plan works:
|Primary Care Doctor:||$15 co-payment|
|Physician Specialist:||$15 co-payment|
|Occupational Therapist:||$15 co-payment|
|Physical Therapist:||$15 co-payment|
|Speech Terapist:||$15 co-payment|
If you are admitted to a hospital or clinic for treatment and stay overnight, you are an inpatient. Most plans have tiered costs for inpatient treatment. Here's how this plan covers you:See Summary of Benefits.
The following preventative healthcare services are covered at no cost:
- Abdominal aortic aneurysm screening
- Alcohol misuse counseling
- Bone mass measurement
- Breast cancer screening (mammogram)
- Cardiovascular disease (behavioral therapy)
- Cardiovascular screenings
- Cervical and vaginal cancer screening
- Colorectal cancer screenings
- Depression screening
- Diabetes screenings
- HIV screening
- Medical nutrition therapy services
- Obesity screening and counseling
- Prostate cancer screenings (PSA)
- Sexually transmitted infections screening and counseling
- Tobacco use cessation counseling
- Vaccines including Flu shots Hepatitis B shots Pneumococcal shots
- Welcome to Medicare preventive visit
- Yearly Wellness visit
Prescription Drug Coverage
This plan includes Medicare Part D coverage for your prescription medications. The table below outlines what you will pay (the copayment) at your pharmacy for medications at each tier level.
If you are entitled to Part D assistance, your premium will be adjusted based on your percentage.
The Part D deductible on plan is $50.00. This is the amount you will pay until the plan begins to pay its portion.
Medicare Plan Rating
Medicare gave the SeniorCare Preferred - Enhanced Rx plan an average rating of -1.0 out of 5 stars. This rating is , by Medicare's definition.
Medicare rates the quality of all Medicare Advantage plans. Ratings help shopper considering enrollment. Five stars represents the best quality. Plans rated less than 2.5 stars cannot be sold.
Compare SeniorCare Preferred - Enhanced Rx with these top rated plans available in Coke County:
- SeniorCare Preferred
- SeniorCare Select
- SeniorCare Select - Value Rx
- SeniorCare VIP
- SeniorCare VIP - Basic Rx
SeniorCare Preferred - Enhanced Rx Availability
SeniorCare Preferred - Enhanced Rx is available in Bronte, Tennyson, Silver, Robert Lee, and all other areas of Coke County.
This page was last updated on 10/14/2017.
Plan data on Medicare-Plans.net comes from CMS.gov and is subject to change. The Centers for Medicare and Medicaid Services has neither reviewed nor endorsed the information on this site.
This page is a brief summary, not a complete description. Limitations, co-payments, and restrictions may apply. For more information contact the plan directly.
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