2020 Allwell Medicare Essentials (HMO) H0724-5-0 in OH from allwell | HealthPocket

Allwell Medicare Essentials (HMO)

$0/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C)
Insurance Providerallwell
Plan IDH0724-5-0
Plan Year2020
CMS Rating
Plan TypeHMO
Annual Deductible$0.00
Out-of-Pocket Maximum3400

What To Know About This Plan
  • This is a health coverage only plan with no drug coverage

Why We Like This Plan
  • has no additional premium costs outside of your Medicare Part B premium

Overview

Premium
Total monthly premium$0.00
Health plan premium$0.00
Standard Part B premium$135.50
Part B premium reductionNo
Deductible
Health plan deductible$0
Estimated yearly costs
Estimated total yearly costs for care$6,342.00
Out-of-pocket max
Out-of-pocket max$3,400 In-network

Benefits & costs

Doctor services
Primary doctor visit$0 copay
Specialist visit$35 per visit
Tests, labs, & imaging
Diagnostic tests & procedures$0 copay
Lab services$0 copay
Diagnostic radiology services (like MRI)$125
Outpatient x-rays$0-25
Emergency care$90 per visit (always covered)
Urgent care$45 per visit (always covered)
Hospital services
Inpatient hospital coverage$200 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage$185 per visit
Skilled nursing facility
Skilled nursing facility$0 per day for days 1 through 20
$170 per day for days 21 through 100
Preventive services
Preventive services$0 copay
Ambulance
Ground ambulance$295
Therapy services
Occupational therapy visit$0 copay
Physical therapy & speech & language therapy visit$0 copay
Mental health services
Outpatient group therapy with a psychiatrist$30
Outpatient individual therapy with a psychiatrist$30
Outpatient group therapy visit$30
Outpatient individual therapy visit$30
Opioid treatment services
Opioid treatment servicesCovered
Other services
Durable medical equipment (like wheelchairs & oxygen)20% per item
Prosthetics (like braces, artificial limbs)20% per item
Diabetes supplies0-20% per item

Extra benefits & costs

Hearing
Hearing exam$35
Fitting/evaluationNot covered
Hearing aids - Inner earNot covered
Hearing aids - Outer earNot covered
Hearing aids - Over the earNot covered
Preventive dental
Oral exam$0 copay
Cleaning$0 copay
Fluoride treatmentNot covered
Dental x-rays$0 copay
Comprehensive dental
Non-routine servicesNot covered
Diagnostic services$0 copay
Restorative services$0 copay
Endodontics$0 copay
Periodontics$0 copay
Extractions$0 copay
Prosthodontics, other oral/maxillofacial surgery, other services$0 copay
Vision
Routine eye exam$0 copay
Contact lenses$0 copay
Eyeglasses (frames & lenses)$0 copay
Eyeglass frames (only)Not covered
Eyeglass lenses (only)Not covered
UpgradesNot covered
More benefits
Fitness benefitLimited coverage
Over the counter drug benefitsLimited coverage
In-home support servicesNot covered
Routine chiropractic serviceLimited coverage
Home and bathroom safety devicesNot covered
Meals for short durationNot covered
Annual physical examsLimited coverage
TelehealthNot covered

Drug coverage & costs

Part B drugs
Chemotherapy drugs20%
Other Part B drugs20%

Coverage Area for Allwell Medicare Essentials (HMO)

StateOhio
CountyFranklin

Staying healthy - screenings, tests and vaccines

Breast cancer screeningNot Rated
Colorectal cancer screeningNot Rated
Annual flu vaccine
Improving or maintaining physical healthNot Rated
Improving or maintaining mental healthNot Rated
Monitoring physical abilityNot Rated
Adult BMI assessmentNot Rated

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain assessmentNot Rated
Osteoporosis management in women who had a fractureNot Rated
Diabetes care – eye exam
Diabetes care – kidney disease monitoringNot Rated
Diabetes care – blood sugar controlled
Rheumatoid arthritis managementNot Rated
Reducing the risk of fallingNot Rated
Improving bladder controlNot Rated
Medication reconciliation post-discharge
Plan all-cause readmissionsNot Rated
Statin Therapy for Patients with Cardiovascular DiseaseNot Rated

Member Experience with Health Plan

Getting needed careNot Rated
Getting appointments and care quickly
Customer service
Rating of health care qualityNot Rated
Rating of health plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Health plan quality improvementNot Rated

Health Plan Customer Service

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

Drug Plan Customer Service

Call center – foreign language interpreter and TTY availability
Appeals auto-forward
Appeals upheldNot Rated

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Drug plan quality improvementNot Rated

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugsNot Rated

Drug Pricing and Patient Safety

MPF Price Accuracy
Medication adherence for diabetes medications
Medication adherence for hypertension - RAS antagonists
Medication adherence for cholesterol - Statins
MTM program completion rate for CMR
Statin use in persons with diabetes - SUPD

Physicians that accept Allwell Medicare Essentials (HMO) for Ohio

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Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
COST:from $0CMS Rating:Not Rated
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Aetna Medicare Premier (HMO)
COST:from $0CMS Rating:Not Rated
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Allwell Medicare (HMO)
COST:from $0CMS Rating:
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Bright Advantage (HMO)
COST:from $0CMS Rating:Not Rated
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UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
COST:from $0CMS Rating:Not Rated
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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).

Medicare Plans Found

 

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).