2018 EON SELECT (HMO) H6672-004-000 in GA from Eon Health | HealthPocket

EON SELECT (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderEon Health
Plan IDH6672-004-000
Plan Year2018
CMS RatingNot Rated
Plan TypeHMO
Annual Deductible$250.00
Out-of-Pocket Maximum6700

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2020. 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

Costs and Other Important Information

Plan Year2018
Optional Supplemental BenefitsNo
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$6,700 In-network
Other health plan deductibles?No
Health Plan Deductible$0
Monthly Drug Plan Premium$0.00
Monthly Health Plan Premium$0.00

Benefits

SERVICECOST
Inpatient hospital coverage$300 for days 1 through 5
$0 for days 6 through 90
Outpatient hospital coverage$225 per visit
Doctor visitsPrimary:
$10 per visit
Specialist:
$50 per visit
Preventive care$0 copay
Emergency care/Urgent careEmergency:
$80 per visit (always covered)
Urgent care:
$50 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:
20%
Lab services:
$5
Diagnostic radiology services (e.g., MRI):
20%
Outpatient x-rays:
$25
Mental health services$300 for days 1 through 5
$0 for days 6 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 servicesOccupational therapy visit:
$40
Physical therapy and speech and language therapy visit:
$40
Ambulance$225
TransportationNot covered
Foot care (podiatry services)Foot exams and treatment:
$45
Routine foot care:
Not covered
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):
20% per item
Prosthetics (e.g., braces, artificial limbs):
20% per item
Diabetes supplies:
20% per item
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:
20%
Other Part B drugs:
20%

Coverage Area for EON SELECT (HMO)

StateGeorgia
CountyGwinnett

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$4 copayNot offered
Tier 2: Non-Preferred GenericNot offereds$15 copayNot offered
Tier 3: Preferred Brand NameNot offereds$47 copayNot offered
Tier 4: Non-Preferred Brand NameNot offereds$100 copayNot offered
Tier 5: Specialty TierNot offereds28% coinsuranceNot offered
Tier 6: Select Care Drugs

60 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$8 copayNot offered
Tier 2: Non-Preferred GenericNot offereds$30 copayNot offered
Tier 3: Preferred Brand NameNot offereds$94 copayNot offered
Tier 4: Non-Preferred Brand NameNot offereds$200 copayNot offered
Tier 5: Specialty TierNot offereds28% coinsuranceNot offered
Tier 6: Select Care Drugs
90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$12 copayNot offered
Tier 2: Non-Preferred GenericNot offereds$45 copayNot offered
Tier 3: Preferred Brand NameNot offereds$141 copayNot offered
Tier 4: Non-Preferred Brand NameNot offereds$300 copayNot offered
Tier 5: Specialty TierNot offereds28% coinsuranceNot offered
Tier 6: Select Care Drugs

Physicians that accept EON SELECT (HMO) for Georgia

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Medicare Plans Found

 

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Health Insurance Innovations, Inc. family of companies (NASDAQ: HIIQ).