Banner Medisun MedisunONE Classic Plus and Premier Review

Banner Medison offers Medicare health plans in Maricopa and Pinal counties in Arizona.  They have been serving members there for over ten years and pride themselves on being a local company that cares about their community.  They offer six Service Centers where members are able to go in and speak to someone face to face.  This is actually a huge benefit, as many Medicare companies are regional or national, and it is almost impossible to speak to someone locally about your coverage.  They offer three Medicare Advantage plans in these counties called:  MedisunONE Classic, MedisunONE Plus, and MedisunONE Premier.  Let’s take a look at some of the most commonly used benefits:

MedisunONE Classic (HMO)

  • Premium – $0/monthly
  • Out of Pocket Maximum – $6,700
  • Referrals Required for some Specialists
  • Hospital Copay – $265/day Days 1-6
  • Doctor’s Visits – Primary = $25; Specialist = $50
  • Outpatient Surgery – $0 – $200 copay
  • Labs – $0 – $5 copay
  • Diagnostic Procedures/Tests - $0 – $5 copay
  • X-rays – $5 – $300
  • Part D Deductible – $0
  • Part D Drug Copays – Tier 1 = 13%; Tier 2 = 13%; Tier 3 = 13%; Tier 4 = 25%
  • No preventative dental, vision, or hearing coverage provided

MedisunONE Plus (HMO)

  • Premium – $14/monthly
  • Out of Pocket Maximum – $6,700
  • Referrals Required for some Specialists
  • Hospital Copay – $125/day Days 1-4
  • Doctor’s Visits – Primary = $10; Specialist = $30
  • Outpatient Surgery – $0 – $150 copay
  • Labs – $0  copay
  • Diagnostic Procedures/Tests – 0% – 20% copay
  • X-rays – $5 – $275
  • Part D Deductible – $0
  • Part D Drug Copays – Tier 1 = $4; Tier 2 = $40; Tier 3 = $80; Tier 4 = 33%
  • No preventative dental
  • Hearing and Vision – $20 copay for exams

MedisunONE Premier (HMO)

  • Premium – $45/monthly
  • Out of Pocket Maximum – $6,700
  • Referrals Required for some Specialists
  • Hospital Copay – $50/day Days 1-3
  • Doctor’s Visits – Primary = $5; Specialist = $15
  • Outpatient Surgery – $0 – $100 copay
  • Labs – $0  copay
  • Diagnostic Procedures/Tests – 0% – 20% copay
  • X-rays – $5 – $250
  • Part D Deductible – $0
  • Part D Drug Copays – Tier 1 = $4; Tier 2 = $30; Tier 3 = $80; Tier 4 = 33%
  • No preventative dental
  • Hearing and Vision – $20 copay for hearing exam and $10 copay for eye exam
In most cases, I recommend going with the no premium plan when a company offers multiple plans with different premiums and benefits.  This company, however; offers three competitive plans for your consideration.  The benefits in the premium plans are fairly robust.  Definitely, consider your health when choosing which one of these plans to enroll into.  Also, not that the plans are HMO’s so you will want to make sure that your providers are in the plan’s network!