PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
Coventry Health Care
CMS Rating
Plan Type
HMO
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage

Why We Like This Plan

  • has both Health and Drug Coverage
  • has no additional premium costs outside of your Medicare Part B premium
  • Primary care physician office visit copay of $0
  • has a copay of $0 for Tier 1 preferred generic drugs (30 day supply, preferred retail pharmacies)

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$3 copay$0 copay
Tier 2: Non-Preferred Generic$30 copay$40 copay$30 copay
Tier 3: Preferred Brand Name$65 copay$80 copay$65 copay
Tier 4: Non-Preferred Brand Name33% coinsurance33% coinsuranceNot offered
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$0 copay$6 copay$0 copay
Tier 2: Non-Preferred Generic$60 copay$80 copay$60 copay
Tier 3: Preferred Brand Name$195 copay$240 copay$195 copay
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

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

Managing Chronic Conditions

Care for older adults – medication review
Care for older adults – functional status assessment
Care for older adults – Pain screening
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Diabetes care – cholesterol controlled
Controlling blood pressure
Rheumatoid arthritis management
Improving bladder control
Reducing the risk of falling
Plan all-cause readmissions

Ratings of Plan Responsiveness and Care

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan

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

Complaints about the health plan
Beneficiary access and performance problems
Members choosing to leave the plan
Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability

Physician Finder

Physicians that accept Coventry Summit Ideal (HMO) for Florida

/
COHEN, SHELDON
9000 SW 137TH AVE
MIAMI, FL 33186
MEZEY, ROBERT
12600 SW 120TH ST
MIAMI, FL 33186
GENAO, ESTEBAN
13059 SW 112TH ST
MIAMI, FL 33186
ROJAS, ROMEO
12002 SW 128TH CT STE 204
MIAMI, FL 33186
JIMENEZ, MILTON
12002 SW 128TH CT STE 204
MIAMI, FL 33186
NUNEZ, LOURDES
12002 SW 128TH CT
MIAMI, FL 33186
HERRERA, MAURICIO
11801 SW 90TH ST
MIAMI, FL 33186
TAYLOR, MARTIN
8501 SW 124TH AVE
MIAMI, FL 33183
PANDO, JARY
13001 SW 88TH ST
MIAMI, FL 33186
MARTINEZ-RAMOS, MARIA
9000 SW 137 AVE
MIAMI, FL 33186
ZAMBRANA, NOREEN
14687 SW 104TH ST
MIAMI, FL 33186
JACQUEMIN, THIERRY
10254 SW 128TH CT
MIAMI, FL 33186
HERNANDEZ, OSCAR
14221 SW 120TH ST
MIAMI, FL 33186
ROCHER, MARAY
11981 SW 97TH TER
MIAMI, FL 33186
GARCIA-ORTIZ, SANDRA
11435 SW 133RD CT APT 3
MIAMI, FL 33186
VALDES-RAFULS, JACQUELINE
8000 SW 117TH AVE
MIAMI, FL 33183
FANILLA, EDUARDO
6963 SW 117TH AVE
MIAMI, FL 33183
PINERA-LLANO, AYLEEN
8501 SW 124TH AVE
MIAMI, FL 33183
MORALES, PEDRO
8200 SW 117TH AVE STE 110
MIAMI, FL 33183
WATSON, EDWARD
6660 SW 117TH AVE
MIAMI, FL 33183
HASAN, ANTHONY
8501 SW 124TH AVE STE 112
MIAMI, FL 33183
ROSS, MICHAEL
8200 SW 117TH AVE
MIAMI, FL 33183
RUIZ, CAMILO
1409 SE 1ST AVE
FORT LAUDERDALE, FL 33316
QUESADA, RAMON
8950 N KENDALL DR
MIAMI, FL 33176
BLINN, RANDALL
11440 SW 88TH ST
MIAMI, FL 33176
Details
SHELDON COHEN, M.D.
Phone Number
(305) 380-6773
Office Locations
9000 SW 137TH AVE
MIAMI, FL 33186
9000 SW 137TH AVE MIAMI FL, 33186

Community Q&A

Do you have questions about this plan?

Get answers from the HealthPocket community.

Similar Plans

PremiumPlan NameCMS Rating
$0.00
Leon Medical Centers Health Plans - Leon Cares (HMO)
Select
$0.00
CareOne PLUS (HMO)
Select
$0.00
Humana Gold Plus H1036-054C (HMO)
Select
$18.60
WellCare Classic (PDP)
Select
$0.00
AvMed Medicare Choice (HMO)
Select

Related Articles

Related Searches

{"phone":"8008957124","helpInfo":{"leadCopy":"Speak with a licensed agent","phone":"8008957124"},"bannerData":{"phone":"8008957124","text":"Open Enrollment is Now.","text2":"Speak With a Licensed Agent"},"analyticsInfo":{"pageType":"details","productLine":"medicare","phone":"8008957124"},"globalPhoneNumber":"8008957124","partner":"TruBridge"}