PARTCRX

Plan Summary

Insurance Type
Medicare Advantage Plan (Part C w/ RX)
Insurance Provider
Kaiser Permanente
CMS Rating
Plan Type
AB) (Cost
Annual Deductible
$0.00

What To Know About This Plan

  • This plan has health and drug coverage

Plan Details

Costs and Other Important Information

Plan Year:
2014
Optional Supplemental Benefits?
No
Choice of Doctors?
Plan Doctors Only
Prescription Drugs Covered?
Yes
Out-Of-Pocket Spending Limit
$3,400 In-Network
Other Deductibles?
In Network: No. Out of Network: No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
In Network
Out of Network
Doctor Office Visits
$20 maximum per visit
Not Applicable
Specialist Office Visit
$30 maximum per visit
Not Applicable
Outpatient Services
$150 maximum per visit
Not Applicable
Emergency Care
$65 maximum per visit
Not Applicable
Ambulance Services
$150 maximum
Not Applicable
Kidney Disease and Conditions
$0
Not Applicable
Home Health Care
$0
Not Applicable
Durable Medical Equipment
20% maximum per item
Not Applicable
Inpatient Hospital Care
$500 copay
Not Applicable
Skilled Nursing Facility (SNF)
Days 1-20: $0 copay per day. Days 21-100: $88 copay per day
Not Applicable
Inpatient Mental Health Care
$500 copay
Not Applicable

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$7 copay$10 copay$7 copay
Tier 2: Non-Preferred Generic$28 copay$33 copay$28 copay
Tier 3: Preferred Brand Name$40 copay$45 copay$40 copay
Tier 4: Non-Preferred Brand Name$90 copay$95 copay$90 copay
Tier 5: Specialty Tier25% coinsurance25% coinsurance25% coinsurance
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$21 copay$30 copay$14 copay
Tier 2: Non-Preferred Generic$84 copay$99 copay$56 copay
Tier 3: Preferred Brand Name$120 copay$135 copay$80 copay
Tier 4: Non-Preferred Brand Name$270 copay$285 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
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
Not Rated

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 Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost) for Maryland

/
REES, RICHARD
2435 W. BELVEDERE AVE
BALTIMORE, MD 21215
BOATENG, JULIUS
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
ABBAS, FOUAD
2411 W BELVEDERE AVE
BALTIMORE, MD 21215
ELLIOTT, MELINDA
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
KOHN, NELSON
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
BALTAZAR, ROMULO
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
CYMET, TYLER
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
DUTTA, SUDHIR
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
ENGSTROM, KAREN
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
GHEORGHIU, IOANA
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
MCGINLEY, PATRICK
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
FRAYHA, RIDA
3640 FORDS LN
BALTIMORE, MD 21215
PINKSTAFF, SALLY
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
SHEVITZ, DAVID
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
OBRIEN, THOMAS
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
LI, CHRISTINA
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
JACKSON, CHERYL
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
JACOBSTEIN, JULIE
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
KARESH, JAMES
2411 W BELVEDERE AVENUE, 6TH FLOOR
BALTIMORE, MD 21215
MURTHY, KALPANA
2411 W BELVEDERE AVENUE, SUITE 407
BALTIMORE, MD 21215
URBAITIS, JOHN
2401 W BELVEDERE AVE
BALTIMORE, MD 21215
SOBHANI, RAMONA
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
WEISMAN, CARLA
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
SINGH, AMANDEEP
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
ROBY, ROBERT
2435 W BELVEDERE AVE
BALTIMORE, MD 21215
Details
RICHARD REES, M.D.
Phone Number
(410) 601-6840
Office Locations
2435 W. BELVEDERE AVE
BALTIMORE, MD 21215
2435 W. BELVEDERE AVE BALTIMORE MD, 21215

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