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Items to Consider:Regular MedicareIRMP Anthem Medicare Preferred (PPO)CostsPremiumsPart A (no charge for people that paid into SS)Part B ______ (insert your monthly Part B premium here) Part A (no charge for people that paid into SS)Part B______ (insert your monthly Part B premium here)Additional Premium : $371DeductiblesPart A= $1408 Part B=$145$500/yrCo-paysDr VisitsHospitalization20% of the?Medicare-approved amount?for hospitalizations > 60 days additional co-pays$15 Dr, $30 SpecialistInpatient copay: $500 per admin, $1500 out of pocket max/yrAdditional co-pays see ? HYPERLINK "" \t "_blank" Anthem Medicare Preferred (PPO) with SeniorRx Plus Pre-Enrollment GuideYearly Out of Pocket Max ?(how much spent)NO$5000Coverage Basic Any ExtrasCoverage in Original MedicareMedicare covers medical services and supplies in hospitals, doctors’ offices, and other health care settings. Services are either covered under?Part A?or?Part B.Plans must cover all of the services that Original Medicare covers. Also covers: Post-discharge healthy meal deliveryUrgent coverage outside the USEnhanced Chiropractic & Acupuncture CoveragePrescription Drug benefitsDrug coverage exceeds minimum standard Medicare requiresHearing benefitsAdditional extras see ?Anthem Medicare Preferred (PPO) with SeniorRx Plus Pre-Enrollment GuideYour Other Coverage*If you have other types of health or prescription drug coverage, make sure you understand how that coverage works with Medicare.*If you have employment-related coverage, or get your health care from an Indian Health or Tribal Health Program, talk to your?benefits?administrator or insurer before making any changes.Medigap Policies You can add a?Medigap policy?to help pay your out-of-pocket costs in Original Medicare, like your?deductible?and?coinsurance?.Supplemental Plan Letter Plan ______, Monthly Premium Cost ________ (insert here)Your Medigap policy may pay deductibles for Part A and Part B as well as co-pays, and excess charges. Consider that in your cost analyses.Prescription DrugsWhat will your prescription drugs cost under each plan? Are your drugs covered under the plan's?formulary? Are there any coverage rules that apply to your prescriptions?Part D drug plan premium ______ (insert here)Yearly expected cost of drugs on plan _________(insert here)You may find this info your providers website (using the Formulary with your personal drug list and selected pharmacy) Covered. $250 deductibleCheck your drug list against Anthem plan drug list to understand coverage and costsYearly expected cost of drugs on plan including deductible ________ (insert here)Access a full list of covered drugs: Our First Impressions Welcome Team can check the full drug list for you. Give them a call at 1-800-811-2711, TTY: 711, Monday through Friday, 5 a.m. to 6 p.m. PT, except holidaysDoctors and Hospital ChoiceDo your doctors accept the coverage? Are the doctors you want to see accepting new patients? Do you have to choose your hospital and health care providers from a?network? Do you need to get referrals?Any Dr or hospital that accepts Medicare, no referrals necessary – US wideChoose any Dr that accepts Medicare & the Advantage PPO nationwide, without referralIncludes in and out of network coverage (See Anthem’s Your Medicare Enrollment Guide)US wideQuality of CareAre you satisfied with your medical care? The quality of care and services offered by plans and other health care providers can vary. How have Medicare and other people with Medicare rated your health and drug plan’s care and services??Get help comparing plans and providers.Use this link to find ratings of health care providers: can chose any provider as long as they take MedicareUse this link to find ratings of health care providers: any Dr that accepts Medicare & the Advantage PPO nationwideTravelAre there healthcare benefits that can be accessed while traveling outside of the US ?Yes, if you have certain types of Supplemental insurance. Use below link to see what travel benefits are associated with which Supplemental plans: or urgently needed care services while traveling outside the United States or its territories during a temporary absence of less than six months. Outpatient copay is waived if member is admitted to hospital within 72 hours for the same condition.Calculate total out of pocket costs per year to evaluate costs: For Medicare Basic: (Medicare Part B + possible Medicare Supplemental Plan Premiums + possible Part D drug plan Premiums + deductibles)All monthly Premiums times 12 months per year + Deductibles MINUS any Deductibles paid by “Your other coverage”For Medicare Anthem Advantage (Medicare Part B + Anthem Advantage Premiums+ deductibles)Evaluate cost of co-pays: that are variable based on your usage of healthcare servicesFor Medicare Basic: consider co-pays that are not reimbursed by “Your other coverage”For Medicare Anthem Advantage See Anthem Medicare Preferred (PPO) with SeniorRx Plus Pre-Enrollment Guide for detailed description of co-paysEvaluate cost of RX : For Medicare Basics: IF you choose a Part D Plan: Look at Monthly premiums times 12 + cost per year of your Drug list, at the pharmacy you choose to use for your possible Part D plan For Medicare Anthem Advantage: Look at cost per year of your Drug list, at the pharmacy you choose by contacting Our First Impressions Welcome Team (see above) ................
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