Reviewing The Best Medicare Plans and Medicare Insurance

Southeast Community Care Plus HMO Georgia and NC Review

Southeast Community Care is offered through Arcadian Health Plan.  Arcadian offers Medicare Health and Prescription drug coverage in several states.  Southeast Community Care Plus plan is a Medicare Advantage HMO plan that is available in Georgia, North and South Carolina, and Virginia.  Medicare Advantage plans offer alternative coverage to original Medicare and a prescription drug plan.  In order to see if these plans make sense for you we need to look at how they cover some of the most important health items.

Southeast Community Care Plus (Georgia)

  • Premium – $0/monthly
  • Maximum Out of Pocket – $3,400 or $6,700
  • Referral required for specialists
  • Hospital copay – $200/day Days 1-5 or $265/day Days 1-6
  • Doctors visits – $20 = Primary; $50 = Specialists; or $10 and $35
  • Outpatient Surgery – $350 or $200
  • Labs – $0
  • Diagnostic Procedures and Tests – $0
  • X-rays – 20%
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $2 or $4; Tier 2 = $15; Tier 3 = $45; Tier 4 = $89; Tier 5 = 33%
  • Preventative dental available in some counties with up to $1000 for comprehensive
  • Routine hearing exams covered in some counties with up to $1,200 for hearing aids
  • Eye exam and glasses covered up to $100 every two years

Southeast Community Care Plus (North Carolina)

  • Premium – $59/monthly
  • Maximum Out of Pocket – $5,900 or $6,700
  • Referral required for specialists
  • Hospital copay – $265/day Days 1-6
  • Doctors visits – $20 = Primary; $50 = Specialists; or $10 and $45
  • Outpatient Surgery – $400
  • Labs – $0
  • Diagnostic Procedures and Tests – $0
  • X-rays – 20%
  • Part D Deductible – $0
  • Part D Drugs – Tier 1 = $2; Tier 2 = $12 or $15; Tier 3 = $45; Tier 4 = $89; Tier 5 = 33%
  • Dental cleanings and x-rays covered 20% copay
  • Routine hearing exams not covered
  • Eye exam and glasses covered up to $70 every two years

You must live in one of the plan’s counties in order to enroll into the plan.  Note:  these benefits may vary from county to county as they are county specific.  This is why you see the different copay amounts listed.  Since these plans are HMO’s you will want to make sure your providers are in the plan’s network before enrolling.

 

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