|Part D Benefit:||No|
|Rx Gap Coverage:|
SeniorCare Preferred 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 $90.00. This amount is paid directly to Insurance Company of Scott & White.
This plan has a monthly premium, but it isn't the full cost. The plan's premium is in addition to your Medicare Part B premium. If your income is over $85,000 ($170,000 for married couples), or you have a penalty due to late enrollment, you'll pay the standard 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
All 2018 Medicare Advantage plans have a $6,700 maximum out-of-pocket (MOOP) limit. That said, Medicare allows for a voluntary MOOP as low as $3,400.This plan's MOOP is $3,400. This figure is not inclusive of your monthly premium or the cost of your prescriptions (Medicare Part D Coverage).
This means that you will no longer pay copayment or coinsurance as soon as your copayments and coinsurance for doctor visits and hospital care reaches $3,400. This is your guarantee that an illness or accident will send you into bankruptcy. Consider the MOOP along with the premium and the copay.
If you're comparing this plan with Original Medicare, don't forget that you pay about 20% of all covered expenses, but there's no limit. You have a lot of risk with Original Medicare unless you buy a Medicare Supplement to cover your copayments and coinsurances.
Coverage, Copayments & Coinsurance
The SeniorCare Preferred 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 does not include Medicare Part D prescription drug coverage. If you enroll in this plan you will need to choose a stand-alone Part D plan. The following stand-alone plans are available in Texas:
Medicare Plan Rating
Medicare gave the SeniorCare Preferred plan an average rating of -1.0 out of 5 stars. This rating is , by Medicare's definition.
Each Medicare Advantage plan receives a 1.0 to 5.0 star rating by Medicare (annually). The quality assessment of plans helps people considering enrollment. A plan with 5 stars has the highest quality.
Compare SeniorCare Preferred with these top rated plans available in Coke County:
- SeniorCare Select
- SeniorCare Select - Value Rx
- SeniorCare VIP
- SeniorCare VIP - Basic Rx
- SeniorCare VIP - Enhanced Rx
SeniorCare Preferred Availability
SeniorCare Preferred is available in Robert Lee, Bronte, Tennyson, Silver, 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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