Cigna-HealthSpring Achieve Plus (HMO SNP)

Medicare Advantage Plan for Arizona

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderCigna
Plan IDH0354-27-0
CMS Rating1
Plan TypeHMO SNP
Annual Deductible$200.00

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

Plan Details

Costs and Other Important Information

Plan Year:
2018
Optional Supplemental Benefits
Yes
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$4,150 In-network
Other health plan deductibles?
No
Health Plan Deductible
$0
Monthly Drug Plan Premium
$0.00
Monthly Health Plan Premium
$0.00

Benefits

Service
Cost
Inpatient hospital coverage
$200 for days 1 through 7
$0 for days 8 through 90
Outpatient hospital coverage
$0-325 per visit
Doctor visits
Primary:
$0 copay
Specialist:
$25 per visit
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$80 per visit (always covered)
Urgent care:
$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
$0 copay
Lab services:
$0-20
Diagnostic radiology services (e.g., MRI):
$0-150 or 20%
Outpatient x-rays:
$0 copay
Mental health services
$185 for days 1 through 8
$0 for days 9 through 90
Outpatient group therapy visit with a psychiatrist:
$40
Outpatient individual therapy visit with a psychiatrist:
$40
Outpatient group therapy visit:
$40
Outpatient individual therapy visit:
$40
Skilled Nursing Facility
$0 for days 1 through 20
$167 for days 21 through 100
Rehabilitation services
Occupational therapy visit:
$25
Physical therapy and speech and language therapy visit:
$25
Ambulance
$200
Transportation
$0 copay
Foot care (podiatry services)
Foot exams and treatment:
$0 copay
Routine foot care:
$0 copay
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for Cigna-HealthSpring Achieve Plus (HMO SNP)

StateArizona
CountyYuma

Cost Sharing Information

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$2 copay$7 copayNot offered
Tier 2: Non-Preferred Generic$10 copay$15 copayNot offered
Tier 3: Preferred Brand Name$42 copay$47 copayNot offered
Tier 4: Non-Preferred Brand Name$95 copay$100 copayNot offered
Tier 5: Specialty Tier29% coinsurance29% coinsuranceNot offered
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$5 copay$21 copayNot offered
Tier 2: Non-Preferred Generic$25 copay$45 copayNot offered
Tier 3: Preferred Brand Name$126 copay$141 copayNot offered
Tier 4: Non-Preferred Brand Name$285 copay$300 copayNot offered
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care management
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
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

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

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Not Rated
Appeals upheld
Not Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physician Finder

Physicians that accept Cigna-HealthSpring Achieve Plus (HMO SNP) for Arizona

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KAYE, ROBERT
1501 W 24TH ST
YUMA, AZ 85364
KHONA, RAJESH
2400 S AVENUE A
YUMA, AZ 85364
BEZWADA, VISHNU
2045 S 14TH AVE UNIT 11
YUMA, AZ 85364
SANGHVI, ASHESH
1030 W 24TH ST
YUMA, AZ 85364
EVANGELISTA, JEMYLENE
2435 S AVENUE A STE A
YUMA, AZ 85364
LWIN, TIN
2400 S AVE A
YUMA, AZ 85364
ZARGARIAN, MOHAMMAD
2060 W 24TH ST
YUMA, AZ 85364
PLANTE, MARK
381 S MAIN ST
YUMA, AZ 85364
ALROMAIHI, DALAL
2270 S RIDGEVIEW DR
YUMA, AZ 85364
LIN, CHIEH
2400 S AVENUE A
YUMA, AZ 85364
SMYTHE, ROBERT
2775 S 8TH AVE
YUMA, AZ 85364
LAU, AUGUSTINE
2375 S. RIDGEVIEW DRIVE
YUMA, AZ 85364
BELLOT, ISABEL
2851 S AVE B
YUMA, AZ 85364
COHEN, STANTON
1743 W 24TH ST
YUMA, AZ 85364
SUBBU, SONAL
2150 W 24TH ST
YUMA, AZ 85364
CLARK, RICK
1394 W 16TH ST
YUMA, AZ 85364
GALANG, TIMOTHY
1320 W 24TH ST
YUMA, AZ 85364
GROGAN, BRIAN
2911 S 8TH AVE
YUMA, AZ 85364
GASCA-HOLTZ, MARIA
2911 S 8TH AVE
YUMA, AZ 85364
MARTINEZ, ERICK
2911 S 8TH AVE
YUMA, AZ 85364
SUCIU, THOMAS
2911 S 8TH AVE
YUMA, AZ 85364
NGUYEN, LOC
1001 W 16TH ST
YUMA, AZ 85364
MATOS, EMILIA
1073 W 23RD ST
YUMA, AZ 85364
HOURANI, ABDULKADIR
2051 W 25TH ST
YUMA, AZ 85364
Details
ROBERT KAYE, M.D.
Phone Number
(928) 336-7846
Office Locations
1501 W 24TH ST
YUMA, AZ 85364
1501 W 24TH ST YUMA AZ, 85364

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