Gundersen Senior Preferred Value (w/RX) (HMO)

Medicare Advantage Plan (Part C w/ RX)

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Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
Gundersen Lutheran Health Plan
CMS Rating
Plan Type
w/RX) (HMO
Annual Deductible
$100.00

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 been rated 5 stars by CMS
  • was the 3rd best selling plan in Vernon 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$8 copay$8 copayNot offered
Tier 2: Non-Preferred Generic$30 copay$30 copayNot offered
Tier 3: Preferred Brand Name$45 copay$45 copayNot offered
Tier 4: Non-Preferred Brand Name$95 copay$95 copayNot offered
Tier 5: Specialty Tier30% coinsurance30% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$24 copay$24 copayNot offered
Tier 2: Non-Preferred Generic$90 copay$90 copayNot offered
Tier 3: Preferred Brand Name$135 copay$135 copayNot offered
Tier 4: Non-Preferred Brand Name$285 copay$285 copayNot offered
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
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
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 Gundersen Senior Preferred Value (w/RX) (HMO) for Iowa

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Community Q&A

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1 question
enrollment
Q:when can one enroll
Asked by Anonymous 
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