2018 Neighborhood INTEGRITY (Medicare-Medicaid Plan) H9576-1-0 in RI from NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND

Insurance Type	Medicare Advantage Plan (Part C w/ RX)
Insurance Provider	NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND
Plan ID	H9576-1-0
CMS Rating	Not Rated1
Plan Type	Medicare-Medicaid Plan
Annual Deductible	$0.00

Plan Details

State	Rhode Island
County	Providence

All cost-sharing assumes in-network healthcare providers.

Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day Supply	Preferred Retail Pharmacies	Non-Preferred Retail Pharmacies	Mail-Order Pharmacies
Tier 1: Preferred Generic	Not offereds	0% coinsurance	Not offered
Tier 2: Non-Preferred Generic	Not offered	0% coinsurance	Not offered
Tier 3: Preferred Brand Name	Not offered	0% coinsurance	Not offered
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

90 Day Supply	Preferred Retail Pharmacies	Non-Preferred Retail Pharmacies	Mail-Order Pharmacies
Tier 1: Preferred Generic	Not offered	0% coinsurance	Not offered
Tier 2: Non-Preferred Generic	Not offered	0% coinsurance	Not offered
Tier 3: Preferred Brand Name	Not offered	0% coinsurance	Not offered
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

Physicians that accept Neighborhood INTEGRITY (Medicare-Medicaid ) for Rhode Island

Last Name

Location/Distance

Gender

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Premium	Plan Name
from $12 Select	EnvisionRxPlus (PDP)	Details
from $0 Select	AARP MedicareComplete Essential (HMO)	Details
from $17 Select	Aetna Medicare Rx Select (PDP)	Details
from $0 Select	BlueCHiP for Medicare Core (HMO)	Details
from $29 Select	SilverScript Choice (PDP)	Details