CarePoint Advantage (PPO)

Medicare Advantage Plan (Part C w/ RX)

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Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
CarePoint
CMS Rating
Not Rated
Plan Type
PPO
Annual Deductible
$250.00

What To Know About This Plan

  • This plan has health and drug coverage
  • This plan is available for 2015. see plan

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)
  • was the 5th best selling plan in Hudson in 2014

Plan Details

Costs and Other Important Information

Plan Year:
2014
Optional Supplemental Benefits?
Information Not Available
Choice of Doctors?
Information Not Available
Prescription Drugs Covered?
Information Not Available
Out-Of-Pocket Spending Limit
Information Not Available
Other Deductibles?
Information Not Available
Health Plan Deductible
Information Not Available
Monthly Drug Plan Premium
Information Not Available
Monthly Health Plan Premium
Information Not Available

Benefits

Service
In Network
Out of Network
Doctor Office Visits
Information Not Available
Information Not Available
Specialist Office Visit
Information Not Available
Information Not Available
Outpatient Hospital Services
Information Not Available
Information Not Available
Emergency Care
Information Not Available
Information Not Available
Ambulance Services
Information Not Available
Information Not Available
Dialysis
Information Not Available
Information Not Available
Home Health Care
Information Not Available
Information Not Available
Durable Medical Equipment
Information Not Available
Information Not Available
Physical Exams
Information Not Available
Information Not Available
Inpatient Hospital Care (Acute)
Information Not Available
Information Not Available
Skilled Nursing Facility (SNF)
Information Not Available
Information Not Available

Prescription Drug Coverage

Optional Supplemental Benefits

Other Services

Cost Sharing Information

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copayNot offered
Tier 2: Non-Preferred Generic$5 copay$5 copayNot offered
Tier 3: Preferred Brand Name$45 copay$45 copayNot offered
Tier 4: Non-Preferred Brand Name$90 copay$90 copayNot offered
Tier 5: Specialty Tier25% coinsurance25% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$0 copay$0 copay
Tier 2: Non-Preferred Generic$15 copay$15 copay$10 copay
Tier 3: Preferred Brand Name$135 copay$135 copay$90 copay
Tier 4: Non-Preferred Brand Name$270 copay$270 copay$180 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Not Rated
Cholesterol screening for patients with heart disease
Not Rated
Glaucoma testing
Not Rated
Annual flu vaccine
Not Rated
Pneumonia vaccine
Not Rated
Improving or maintaining physical health
Not Rated
Improving or maintaining mental health
Not Rated
Monitoring physical ability
Not Rated
Access to primary care doctor visits
Not Rated
Adult BMI assessment
Not Rated

Managing Chronic Conditions

Care for older adults – medication review
Not Rated
Care for older adults – functional status assessment
Not Rated
Care for older adults – Pain screening
Not Rated
Osteoporosis management in women who had a fracture
Not Rated
Diabetes care – eye exam
Not Rated
Diabetes care – kidney disease monitoring
Not Rated
Diabetes care – blood sugar controlled
Not Rated
Diabetes care – cholesterol controlled
Not Rated
Controlling blood pressure
Not Rated
Rheumatoid arthritis management
Not Rated
Improving bladder control
Not Rated
Reducing the risk of falling
Not Rated
Plan all-cause readmissions
Not Rated

Ratings of Plan Responsiveness and Care

Getting needed care
Not Rated
Getting appointments and care quickly
Not Rated
Customer service
Not Rated
Overall rating of health care quality
Not Rated
Overall rating of plan
Not Rated

Member Complaints, Problems Getting Services, and Choosing to Leave the Plan

Complaints about the health plan
Not Rated
Beneficiary access and performance problems
Not Rated
Members choosing to leave the plan
Not Rated
Plan makes timely decision about appeals
Not Rated
Reviewing appeals decisions
Not Rated
Call center – foreign language interpreter and TTY/TDD availability
Not Rated

Physician Finder

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