Medicare Advantage plan options and details


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2023 benefit overview

See our 2023 additional benefits page for more information.

Up to $240 back on your social security check

$650 a year to spend on out of pocket dental, vision, and hearing services on eligible plans

$50 per quarter to spend on over the counter items

$1500 yearly of preventative and comprehensive dental services

Prevea360 Essential (HMO-POS)

$
0
Monthly Premium
  • Hospital copay
    In-network: $350/day for days 1-5
    Out-of-network: $600/day for days 1-7
  • Primary care copay
    In-network: $0
    Out-of-network: $60
  • Specialist copay
    In-network: $35
    Out-of-network: $60
  • Emergency room copay
    $95
  • Urgent care copay
    $35
  • Ground ambulance
    $275
  • Therapy (physical, occupation, and speech)
    In-network: $40
    Out-of-network: $60
  • Outpatient surgery
    In-network: $350
    Out-of-network: 40% coinsurance
  • Maximum out-of-pocket
    In-network: $4700
    Out-of-network: $6000

Prevea360 FlexSpend (HMO-POS)

$
0
Monthly Premium
  • Hospital copay
    In-network: $350/day for days 1-5
    Out-of-network: $600/day for days 1-7
  • Primary care copay
    In-network: $0
    Out-of-network: $60
  • Specialist copay
    In-network: $35
    Out-of-network: $60
  • Emergency room copay
    $95
  • Urgent care copay
    $35
  • Ground ambulance
    $275
  • Therapy (physical, occupation, and speech)
    In-network: $40
    Out-of-network: $60
  • Outpatient surgery
    In-network: $350
    Out-of-network: 40% coinsurance
  • Maximum out-of-pocket
    In-network: $4700
    Out-of-network: $6000

Prevea360 Harmony (HMO-POS) MA-Only

$
0
Monthly Premium
  • Hospital copay per day
    In-network: $350/day for days 1-5
    Out-of-network: $600/day for days 1-7
  • Primary care copay
    In-network: $0
    Out-of-network: $60
  • Specialist copay
    In-network: $35
    Out-of-network: $60
  • Emergency room copay
    $110
  • Urgent care copay
    $35
  • Ground ambulance
    $275
  • Therapy (physical, occupation, and speech)
    In-network: $40
    Out-of-network: $60
  • Outpatient surgery
    In-network: $350
    Out-of-network: 40% coinsurance
  • Maximum out-of-pocket
    In-network: $4700
    Out-of-network: $6000

Out-of-network/non-contracted providers are under no obligation to treat plan members, except in emergency situations. Please call Customer Care at 1-877-232-7566 (TTY: 711), or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

2023 additional benefit overview

2023 Part D benefit overview 

Prevea360 Essential (HMO-POS) and Prevea360 FlexSpend (HMO-POS)

Prevea360 Harmony (HMO-POS) MA-only: 

Prevea360 Harmony (HMO-POS) does not include Part D Prescription Drug coverage. This is an excellent choice if you already have prescription drug coverage through Wisconsin’s Senior Care Prescription Drug Assistance Program, TRICARE for Life, the VA or an employer plan. You can not have a Medicare Part D Prescription Drug plan if you enroll in the Harmony plan.

Shop 2023 plans
View our Medicare disclaimer.
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Updated: 3/3/23