Virginia Premier Advantage Elite (HMO SNP)

Medicare Advantage Plan for Virginia

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PARTCRX

Plan Summary

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderVirginia Premier Health Plan,
Plan IDH9877-1-0
CMS RatingNot Rated1
Plan TypeHMO SNP
Annual Deductible$405.00

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
No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)
$3,400 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
$0 copay
Outpatient hospital coverage
$0 copay
Doctor visits
Primary:
$0 copay
Specialist:
$0 copay
Preventive care
$0 copay
Emergency care/Urgent care
Emergency:
$0 copay
Urgent care:
$0 copay
Diagnostic procedures/lab services/imaging
Diagnostic tests and procedures:
$0 copay
Lab services:
$0 copay
Diagnostic radiology services (e.g., MRI):
$0 copay
Outpatient x-rays:
$0 copay
Mental health services
$0 copay
Outpatient group therapy visit with a psychiatrist:
$0 copay
Outpatient individual therapy visit with a psychiatrist:
$0 copay
Outpatient group therapy visit:
$0 copay
Outpatient individual therapy visit:
$0 copay
Skilled Nursing Facility
$0 copay
Rehabilitation services
Occupational therapy visit:
$0 copay
Physical therapy and speech and language therapy visit:
$0 copay
Ambulance
$0 copay
Transportation
Not covered
Foot care (podiatry services)
Foot exams and treatment:
$0 copay
Routine foot care:
$0
Medical equipment/supplies
Durable medical equipment (e.g., wheelchairs, oxygen):
$0 copay
Prosthetics (e.g., braces, artificial limbs):
$0 copay
Diabetes supplies:
$0 copay
Wellness programs (e.g., fitness, nursing hotline)
Covered
Medicare Part B drugs
Chemotherapy:
$0 copay
Other Part B drugs:
$0 copay

Coverage Area for Virginia Premier Advantage Elite (HMO SNP)

StateVirginia
CountyChesapeake City

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 GenericNot offereds$0 copayNot offered
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred GenericNot offered$0 copayNot offered
Tier 2: Non-Preferred Generic
Tier 3: Preferred Brand Name
Tier 4: Non-Preferred Brand Name
Tier 5: Specialty Tier

CMS Ratings

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Not Rated
Colorectal cancer screening
Not Rated
Annual flu vaccine
Not Rated
Improving or maintaining physical health
Not Rated
Improving or maintaining mental health
Not Rated
Monitoring physical ability
Not Rated
Adult BMI assessment
Not Rated

Managing Chronic Conditions

Special needs plan care management
Not Rated
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
Not Rated
Diabetes care – eye exam
Not Rated
Diabetes care – kidney disease monitoring
Not Rated
Diabetes care – blood sugar controlled
Not Rated
Controlling blood pressure
Not Rated
Rheumatoid arthritis management
Not Rated
Reducing the risk of falling
Not Rated
Plan all-cause readmissions
Not Rated

Member Experience with Health Plan

Getting needed care
Not Rated
Getting appointments and care quickly
Not Rated
Customer service
Not Rated
Overall rating of health care quality
Not Rated
Overall rating of plan
Not Rated
Care Coordination
Not Rated

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Not Rated
Members choosing to leave the health plan
Not Rated
Beneficiary access and performance problems
Not Rated
Health plan quality improvement
Not Rated

Health Plan Customer Service

Plan makes timely decision about appeals
Not Rated
Reviewing appeals decisions
Not Rated
Call center – foreign language interpreter and TTY/TDD availability - Medical
Not Rated

Drug Plan Customer Service

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

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Not Rated
Members choosing to leave the drug plan
Not Rated
Beneficiary access and performance problems
Not Rated
Drug plan quality improvement
Not Rated

Member Experience with Drug Plan

Rating of drug plan
Not Rated
Getting needed prescription drugs
Not Rated

Drug Pricing and Patient Safety

MPF Price Accuracy
Not Rated
High risk medication
Not Rated
Part D medication adherence for diabetes
Not Rated
Part D medication adherence for hypertension
Not Rated
Part D medication adherence for cholesterol
Not Rated
Medication Therapy Management program completion rate
Not Rated

Physician Finder

Physicians that accept Virginia Premier Advantage Elite (HMO SNP) for Virginia

/
MOHAN, RAVINDER
5320 PROVIDENCE RD
VIRGINIA BEACH, VA 23464
MANCHIKALAPUDI, PARTHA
844 KEMPSVILLE RD
VIRGINIA BEACH, VA 23464
JACOBS, JOANNE
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
ROBINS, LAURA
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
WERDER, GABRIEL
5544 GREENWICH RD
VIRGINIA BEACH, VA 23462
TANNOUS, GEORGE
828 HEALTHY WAY
VIRGINIA BEACH, VA 23462
HINNANT, LEE
828 HEALTHY WAY
VIRGINIA BEACH, VA 23462
SALSANO, ALESSIO
828 HEALTHY WAY
VIRGINIA BEACH, VA 23462
KUMAR, ANITA
828 HEALTHY WAY
VIRGINIA BEACH, VA 23462
JOHNSON, APRIL
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
BIEDENBENDER, REX
5516 VIRGINIA BEACH BLVD.
VIRGINIA BEACH, VA 23462
EPPLEIN, DIANNE
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
THOMS, JAMES
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
ANDERSON, JUDITH
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
STAHL, JANET
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
RICASA, JOCELYN
828 HEALTHY WAY
VIRGINIA BEACH, VA 23462
PRICE, AMY
256 N WITCHDUCK RD
VIRGINIA BEACH, VA 23462
WILLIAMS, MICHAEL
225 CLEARFIELD AVE
VIRGINIA BEACH, VA 23462
ROBERTO, FRANK
289 INDEPENDENCE BLVD
VIRGINIA BEACH, VA 23462
BARODAWALA, FAYYAZ
5544 GREENWICH ROAD
VIRGINIA BEACH, VA 23462
DIANNE D. EPPLEIN & ASSOCIATES
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
MCATEE, KATHERINE
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
MCDONOUGH, CATHERINE
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
FREEMAN, RUDOLPH
297 INDEPENDENCE BLVD
VIRGINIA BEACH, VA 23462
GERBUS, ERIN
818 NEWTOWN RD
VIRGINIA BEACH, VA 23462
Details
RAVINDER MOHAN, MD
Phone Number
(757) 413-7600
Office Locations
5320 PROVIDENCE RD
VIRGINIA BEACH, VA 23464
5320 PROVIDENCE RD VIRGINIA BEACH VA, 23464

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