Blog

Medicare Supplement Plans

Medicare Supplement Plans, also called “Medigap” insurance, provides extra coverage for Medicare beneficiaries. People in Original Medicare often take Medicare Supplement insurance to cover the gaps in Original Medicare. Medicare has two parts, Part A and Part B.  Both programs have gaps in coverage that a supplement may cover. (Depends on which on is purchased.)

Gaps In Coverage

Part A Gaps:

Medicare Part A (Hospital Insurance) covers inpatient hospital, inpatient skilled nursing facility, home health, and hospice services.  The following is a list of gaps in coverage:

• Hospital deductible per stay
• Hospital coinsurance (Medicare covers the first 60 days in full after the deductible has been met.  Days 61 to 90 have a copayment, and days 91 to 150 – the “lifetime reserve” –  a higher copay.
• No coverage after 150 days.
• Skilled nursing facility coinsurance payments (Medicare covers the first 100 days).
• No coverage after 100 days.
• Home health aide services that are provided on more than a part-time basis.
• Home health nursing and aide services.

See exact amounts for the current year here.

Part B Gaps

Medicare Part B (outpatient coverage) provides coverage for a number of outpatient and physician services.  It also pays for durable medical equipment, prosthetic devices, supplies and ambulance.  The following is a list of gaps Medicare does not cover.

• Part B deductible (annual deductible of $166).
• Part B 20% coinsurance payment (Medicare pays 80% of the allowable charges).
• Balance billing above the Medicare-approved charge (some physicians and providers charge more than the amount Medicare approves).  Billing above Medicare approved amounts not allowed in all states.  The amount they can bill above is limited as well.

Who Needs Medicare Supplement Plans?

There are a number of programs that help fill in the gaps of A and B.

• Government Programs such as QMB or Full Medicaid.
• Group Retirement Plans.
• Standardized Individual Medigap Policies. (Means the plans have the same core benefits.)

If you have Medicaid or are a QMB

Medicare beneficiaries with Medicaid (Title 19 or QMB) usually do not need Medigap insurance because Medicaid will cover their out of pocket costs. Chick here for a short video about Medicaid.  Not all doctors and facilities will take Medicare however.  People who do not qualify for Medicaid may still be eligible for the QMB program. QMB program benefits include:

• The payment of monthly Medicare premiums.
• All costs of Medicare annual deductibles.
• Payment of Medicare coinsurance.

Those not on Medicaid or QMB

People that are not on Medicaid or QMB may want to consider one of the many Medicare supplement plans available.  Currently, there are plans A,B,C,F, High F,G,K,L,M and N. Each plan covers different amounts of the gaps not covered by Original Medicare.  Plans are standardized which means benefits in a plan must be the same from company to company. Example: Plan F has the same benefits no matter who offers it.  A persons health is the biggest factor when choosing between all the options. Price point of a specific plan in an area is a consideration as well. Many people take a Medicare supplement because there is no network to follow.  As a result, the beneficiary may see any provider that accepts Original Medicare when using a Medicare supplement plan.

What is the best Medicare supplement plan option?

There is not a perfect plan for everyone.  Each individual situation is different and as a result, the right supplement for one person may be wrong for another.  In general plans F,N,G,K and High Deductible F have the best price points for the benefit.  This is very dependent on the state you reside in however.  In most states, the best deal for a supplement is the high deductible F supplement.  Most people do not understand how high F works however so they overlook it.   CLICK FOR MORE INFO ON HIGH DEDUCTIBLE F SUPPLEMENT  Note: call our office at 203-796-5403 or email Edward@croweandassociates.com if you want a quote over the phone or sent to you by email.

CT Medicare Supplement Rates                                                             

 NY Medicare Supplement rates

 NJ Rates 

 PA Medicare Supplement rates

 Mass Medicare Supplement Rates 

Florida Medicare Supplement rates

Georgia Medicare Supplement rates

VT Medicare Supplement Rates

 Washington Medicare Supplement 

 Virginia Medicare Supplement Rates 

Arizona Medicare Supplement Rates

California Medicare Supplement Rates

Maine Medicare Supplement Rates

Rhone Island Medicare Supplement Insurance Rates

North Carolina Medicare Supplement

Delaware Medicare Supplement Rates

South Carolina Medicare Supplement

New Hampshire Medicare Supplement

Colorado Medicare Supplement

Iowa Medicare Supplement

Kansas Medicare Supplement

Hawaii Medicare Supplement

Alabama Medicare Supplement

Alaska Medicare Supplement Rates

Idaho Medicare Supplement Rates

Kentucky Medicare Supplement Rates

Ohio Medicare Supplement Rates

Nebraska Medicare Supplement Rates

Maryland Medicare Supplement Rates

North Dakota Medicare Supplement

Oklahoma Medicare Supplement

When do you take a Medicare Advantage plan instead?

A Medicare Advantage Plan is not a supplement. Instead,they are very different types of plans.  A supplement is secondary to Medicare.  A Medicare Advantage plan replaces Medicare and acts as the primary insurance as a result.  There are a number of things to consider when choosing a supplement or Advantage plan.  What doctors will be used?  How often is care received? Does the beneficiary plan to travel? These are just a few things to consider when choosing.

Do they cover prescriptions?

Medicare Supplement Plans do not include Rx coverage.   A beneficiary can consider a stand alone drug plan for coverage because they can not buy a supplement with a drug plan.  Instead they would buy a part D plan from an insurance company. The part D plan can be from a different company than the supplement company.  Part D plans are offered by many companies. They have very different premiums and benefits from one company to the next.

What plans are popular? 

It depends on the state you live in but, in general, plans F, N and G are popular choices.  The high F plan can be the best choice if the cost is low. Some states have low cost High F plans and others do not.  Some states allow you to change from one supplement to another any time.  The change can be made without any type of health check.  Other states will check health if changing plans outside of a guaranteed issue period.

More info about Medicare Supplement plans.

Supplements will only cover services allowed by Medicare. If Medicare does not approve the care, the supplement will not cover it either.  An example is acupuncture which is not covered by Original Medicare. The supplement will not cover the charges either. Medicare supplement benefits do not change every January like they do with an Advantage plan.  The premium is subject to change but the benefits do not.  Medicare supplement plan F will no longer be available as of 2020. As a result, the plan G supplement will be the closest option to a plan F.  This is not a big issue because those in it already can keep it but no one can buy a new plan F as of 2020.

Looking for Medicare information in Connecticut?

Click here for a no cost, confidential Medicare quote.

Medicare Part B Coverage

Medicare Part B coverage is medical insurance.  Part B covers doctor visits.  It also covers well visits.  Coverage for medically necessary services and supplies is provided. This coverage includes any service or supply that you require for either diagnosis and or treatment of a medical condition. Part B also covers outpatient services.  Covered services include those provided by either a hospital, doctor’s office, clinic or other health care facility.

Medicare Part B also covers many preventive services to prevent illness or detect them at an early stage.  Together,  Parts A and Part B are known as Original Medicare.

Medicare Part B benefits

Medical services and supplies covered by Medicare Part B include (but may not be limited to):

• Doctor’s visits,
• Urgent care visits,
• Laboratory tests,
• X-rays,
• Emergency ambulance services,
• Mental health services, and
• Durable medical equipment.
• Preventive services, such as pap tests, flu shots, and screenings.
• Rehabilitative services, including physical therapy, occupational therapy, as well as speech-language pathology services.

Part B has a monthly premium associated with it.  The monthly premium is $104.90 in 2016.  If you get either Social Security, Railroad Retirement Board, or Office of Personnel Management benefits, your Part B premium will be automatically deducted from your benefit payment. If you don’t get these benefit payments, you’ll get a bill.   Note:   If you did no take Part B when you were first eligible, the cost of Part B will go up 10% for each full 12-month period that you  could have had Part B but didn’t sign up for it, except in special cases. You will have to pay this penalty as long as you have Part B.

Click here to learn how and when to enroll in Medicare.

Are you ready to sign up for Medicare?  You can sign up online.  Click here to enroll.

We are one of  the Northeast’s leading Medicare expert brokerages.  We do not charge consultation fees.  Feel free to contact the office at 203-796-5403 if you have questions.

Click here for a free personalized Medicare quote.

Interested in getting a home or auto quote?  We can help with that as well.  Email us at Admin@CroweAndAssociates.com.  We will send you a personal online link to enter your info and request a no obligation quote.

 What is Medicare Part A Coverage?

Medicare Part A coverage is hospital care coverage.  This plan covers both lab tests and surgeries.  Doctor care during the stay is also covered.  There is also coverage for supplies like wheelchairs and walkers when they are medically necessary to treat either a disease or a condition.  Part A covers in-patient hospital stays.  These plans also cover care in a skilled nursing facility or nursing home care as well as Hospice care and some home health services.  Note:  Part A will cover nursing home care for medical purposes.  Medicare will not cover the expense if custodial care is the only care necessary.

Part A includes benefits for hospital expenses.

Other expenses part A covers are, a semi-private room and meals as well as medications.  There is also coverage provided for nursing services and other supplies from the hospital.  Part A benefits will cover home health care services when deemed medically necessary.  Your doctor must order home health services in order for this expense to gain approval. Skilled nursing facility (SNF) stays coverage will only receive approval by Part A after a qualifying hospital inpatient stay for a related illness or injury. To qualify for SNF care, the hospital stay must be a minimum of three days.  A qualified stay begins on the day you are admitted. The day the hospital dischares you does not count toward the 3 day requirement.  Patients can be kept for observation.  Time spent under observation is considered outpatient.  This time does not count towards your qualifying stay.

If your doctor has certified that you have a terminal illness, you may be eligible for hospice care coverage.   Your doctor will need to determine a 6 month or less life expectancy.  In hospice care, the focus is on palliative care.  Hospice focus is not cure.  The goal is to relieve pain and make the patient as comfortable as possible.

Click here to learn how and when to enroll in Medicare.

Click here for more information regarding Medicare Part A  benefit coverage.

Connecticut residents looking to compare plan options can click here for more details about plans available.  If you still have questions or would like to set an appointment, please call the office at 203-796-5403.  In fact, we are leading Medicare experts in CT and are here to help.  We do not charge for our consultation services.

Click here for a no cost personal and confidential Medicare quote.

Medicare Plans Connecticut

Medicare Plans Connecticut is a broad term that can refer to a number of companies or plan types in Connecticut.  Insurance companies offer either Medicare Advantage plans (MAPD), Medicare Supplement plans (Also called Medigap)  or Medicare Part D Rx plans.  A summary of both plans and companies has been provided below.  Choosing the right plan means matching up the needs of the insured (current health, doctors, as well as Medications and volume of care) with the strengths of the given plan type.

Medicare Advantage plans-

Managed Medicare plans offered with (MAPD) and without (MA) drug coverage.  Medicare Advantage plans take the place of Original Medicare.  They are the primary insurance and have a network as a result.  There  in network only (HMO) and out of network (PPO) plans available. In Connecticut, most plans are HMO style plans.  Connecticare, United Healthcare, Aetna and Wellcare as well as Anthem BCBS offer plans in Connecticut.

There are two plans with a $0 monthly premium. Both require referrals to specialists. There are a number of plans in the $29 to $44 a month range. The higher end HMO and PPO plans have a premium from $99 to $128 a month. The positive points with MAPD plans are, they have a very low to no monthly premium.  These plans include Medicare part D coverage and they offer some benefits that Original Medicare does not.  Some of the negatives can be, the copay for medical services, provider networks as well as referrals for specialists.  Click the links for plan designs of some of the more popular plans in CT.

Connecticut does not have medical underwriting which is important to consider.  Medicare rules allow someone to change plans every January 1st during OEP.  Without checking health, a member can change from a Medicare Supplement to a Medicare Advantage plan.  If someone develops a health condition, they could change to a supplement without any issues.

Medicare Plans Connecticut 

United Healthcare Medicare Complete Plan 1

UHC Medicare Complete Plan 2

United Healthcare Medicare Complete Plan 3

Aetna Medicare Plan HMO Connecticut

Anthem Mediblue Plus HMO

Anthem Mediblue Select HMO

Medicare Plans Connecticut can also be Medicare Supplement Plans (Medigap)– Medicare Supplement plans are offered by a number of companies in CT.  These plans are standardized. This means benefits are the same from company to company.  Common plans offered in CT are Plans F, High F, N, K, L and G.  AARP offered by United Healthcare tends to be the first choice in CT.  A number of companies including Humana, AARP, Anthem BCBS, Combined Life, United American and Cigna all offer a number of plan choices.

Click here for standardized Medicare supplement rates in CT

Medicare Part D plans (stand alone Rx plans)-  Medicare part D plans are offered by a number of companies in CT.  Some of the more popular choices are UHC branded Saver, UHC branded Preferred RX, Humana Walmart Rx, Silver Scripts, Express Scripts Rx.  There are too many plans to list them all.   You cannot purchase a stand alone Rx plan with a Medicare Advantage plan.  Clients can only purchase these plans along with a Medicare supplement.  You can also combine these plans with Medicare A and B.  If you buy a supplement plan, you do not have to use the same company for the Rx plan.  Clients can choose any company they feel is offering the best plan for them.  Note: The Humana Walmart Rx plan is  the current lowest cost (lowest monthly premium) plan in CT.

Need to sign up for Original Medicare A and B?  Click this link to sign up online through the Social Security Website.

States offer  programs to individuals in need of assistance.  In fact, you may qualify for assistance.  Click here to learn about programs offered and determine if you are eligible.

 If you have either additional questions or need a quote, Click here.

Medicare Supplement Rates Connecticut

Medicare Supplement Rates Connecticut are available at the bottom of this blog.  These Medicare Supplement plans are also called Medigap plans.  Connecticut is a standardized state for Medicare supplements.  Plans have identical benefits from one company to the next. The only difference is in price and value added features. Value added are things such as Silver Sneakers being available with a plan. A Medicare supplement plan is secondary coverage.  Original Medicare both A and B are the primary insurance with a supplement.  Providers bill Original Medicare first.  The portion not covered by Medicare is sent to the supplement.  The supplement covers some or all of the remainder depending on the the plan chosen. Plan F covers 100%, plan N covers most charges, plan L covers 75% and so on.  There are 9 supplement types in CT

How do you decide which one to take?

It depends on your situation.  People in very poor health may be better with a Plan F.  Someone in average health may look at plan N or plan L.  Supplements have some advantages: No network and ability to choose coverage level are two big ones.  Also, the ability to choose any Part D plan. There are also some negatives. The first is paying three premiums.

A part B premium of $121.80. The Supplement premium and the Rx premium.  Some people will make the decision to go with a Medicare Advantage plan instead. Connecticut does not allow companies to underwrite plans.  This simply means they can’t check your health.  This allows members to move from one supplement to another during the year.  Certain health conditions may cause an issue if you want to change plans.  They could also move either to an advantage during OEP or from an Advantage to a supplement.   Rates have been provided below.  In fact, the grid holds the rates for every company with a supplement in CT.

Click this link for CT rates 2016

Are you looking for Medicare Advantage Plan information instead?

If you need to sign up for Medicare A and B, Click for online enrollment with Social Security

Click here for a no obligation Medicare quote.

Anthem MediBlue Select HMO

Anthem MediBlue Select HMO is a Medicare Advantage plan with prescription drug coverage (MAPD).   In fact, Anthem Blue Cross Blue Shield offers this plan only in Hartford county in the state of Connecticut.   This, like all HMO plans, require that participants use in network providers.  If you choose to use out of network providers, this plan will not cover your expenses.  An exception to this would be urgent or emergency care which allows of of network services.

The plan has a monthly premium of $26. This would be in addition to the part B premium of $121.80.  There are no referrals required for this plan. Co-pays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,100 per year.  Annual maximum indicates the most the insured would need to pay in medical claims for  the year.  You can not apply either Monthly premiums or cost-sharing for part D prescription drugs to the maximum out of pocket amount.

You can add dental services to the plan for an additional premium.  In Addition, Silver Sneakers is included in the $26 monthly premium and pays a local gym membership monthly fee.   If you use approved diabetic supply vendors your diabetic supplies are covered at 100%.

This plan offers prescription drug coverage with $220 annual deductible.  This deductible applies only to tiers 2-5.  The plan excludes both Tiers 1 and 6 from this deductible.  There is no limit to how much the plan will pay.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).

MAPD plans offer both medical and drug benefits combined with the insurance company as the primary insurance.  With a Medicare Supplement, original Medicare is primary.  The insurance company would be the secondary insurance.  As a result, a Medicare Supplement plan does not have a network.  Because members may see any provider that participates with Original Medicare, it is different from an Advantage plan.

 HMO summary of benefits Anthem MediBlue Select

Anthem MediBlue Selelct HMO application

Click here to request a personal Medicare review.

Aetna Medicare Plan HMO Connecticut

Aetna Medicare Plan HMO Connecticut is a Medicare Advantage Plan (MAPD).  This plan is  offered in Fairfield, New Haven, and New London counties.  Aetna refers to this plan as the Shoreline plan. They also offer a similar version of it called “inland”.  The inland plan includes Hartford, Litchfield and Tolland counties. The Aetna Medicare Plan HMO Connecticut is an HMO plan. Members must use in network providers (except for emergency and urgent care).  If  you choose to use an out of network provider in an non emergency or urgent care situation, there will be no coverage at all.  Medicare A and B will not provide the standard 80% part B coverage when going out of network on a Medicare Advantage plan.

In addition to a $6,700 maximum out-of-pocket contribution (for medical expenses only), this Aetna plan is a $0 premium offering and requires referrals to see specialists.  You only need to obtain a referral once per specialist each calendar year.  The plan features very low co-pays for a $0 premium plan. With a $10 primary doctors copay and a $40 specialist copay. Most other co-pays are also low compared to other plans offered in the same market such as a $600 inpatient hospital co-pay and a $150 major radiology copay (basically means MRI’s, CAT and PET scans).

The prescription drug plan (included with benefits of plan)

is one of the few that does not have a deductible on tier 3, 4 and 5 drugs.   Overall, this is a solid plan with a large national network of providers that can be accessed anywhere in the country.  The one benefit that should be noted with this plan is the fact that it does have an annual deductible of $1,000 for some services such as Inpatient hospital, major radiology, Outpatient surgery, ambulance and some other services. A plan summary has been provided below for review.

CLICK HERE FOR AETNA MEDICARE PLAN HMO CONNECTICUT PLAN SUMMARY

Click here for a free Medicare review and quote.

Anthem MediBlue Plus HMO

Anthem MediBlue Plus HMO is a Medicare Advantage plan with prescription drug coverage (MAPD). This plan is offered by Anthem Blue Cross Blue Shield in 4 counties in the state of Connecticut.  Clients can purchase in either Fairfield, Litchfield, New Haven as well as Windham counties.  Given the plan is an HMO plan, participants must use in network providers.  In fact, if you use out of network providers  anthem will not cover your claims. An exception to this would be when getting urgent or emergency care which allows of of network services.

The plan has a monthly premium of $37 a month. This would be in addition to the part B premium of $121.80.  This plan does not require a referral. Copays for a primary doctor are $15 and $40 for a specialist.  The plan has an annual out of pocket max of $6,700 per year. Annual max indicates the most the insured would need to pay in medical claims for  the year. It does not include prescription drug out of pocket costs. You can add dental coverage to this plan for an additional premium. They include Silver Sneakers  in the $37 monthly premium and they pay a local gym membership monthly fee for members. Diabetic supplies are covered at 100% when using approved diabetic supply vendors.

A Medicare Advantage plan should not be confused with a Medicare Supplement plan (also called Medigap).  MAPD plans offered medical and drug benefits combined with the insurance company as the primary insurance. With a Medicare Supplement, Original Medicare is primary.  The insurance company would be the secondary insurance. As a result, a Medicare Supplement plan does not have a network.  In fact, members may see any provider that participates with Original Medicare.  This is not the case with an Advantage plan.

 MediBlue Plus HMO Anthem summary of benefits

Anthem Mediblue Plus HMO application

Click here to request a personal Medicare review.

United Healthcare Medicare Complete Plan 1 Connecticut

United Healthcare Medicare Complete Plan 1 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD).  Medicare Complete Plan 1 is an HMO plan.  This plan is available in all eight Connecticut counties.   The plan has a $99 monthly premium.  The annual out of pocket limit for medical expenses is $4,850.  Primary doctor visit co-pays are $10.   The specialist visit co-pay is $30.   In fact, this plan does not require PCP referrals for specialist visits.    Additional benefits are provided for podiatry care, hearing aids, SilverSneakers fitness program and also the NurseLine.  This plan features contributions for vision exams.  These plans include preventative dental coverage.

The drug plan has a  co-pay plan with 5 tiers as well as a $130 deductible that applies to tiers 3,4 and 5 only.  Like all other part D and MAPD drug plans in CT,  a Coverage Gap (formerly called donut-hole) applies to this RX benefit.  Although it is an HMO plan, the Medicare Complete Plan 1 does have the 2016 UHC Passport Program which provides access to doctors in other states on an in-network basis.  Passport is not available in all states, but they do include it in the Connecticut plan.   A dental benefit is also offered for an additional premium.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement, there is not a network but instead, the insured would go to any provider that accepts or participates with Original Medicare.

A 2016 Summary of benefits as well as a 2016 application are available in the links below.   You can send applications back to us either by email at Admin@croweandassociates.com or by fax at 203-567-6235.

Click here to download the UHC Complet Plan 1 Summary of Benefits – Connecticut

Click here to download the UHC Complete Plan 1 Application – Connecticut

Looking for a lower monthly premium?  Click here to learn more about the United Healthcare Complete Plan 2.

Click here for a no-obligation Medicare quote.

United Healthcare Medicare Complete Plan 2 Connecticut

United Healthcare Medicare Complete Plan 2 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD) offered by United Healthcare Medicare.  Medicare offers the Complete Plan 2  in Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland as well as Windham counties. This plan is a HMO and has both a $29 monthly premium and an annual out of pocket max of $6,000 (Medical only). It features co-pays of $15 for primary doctor visits as well as $40 for specialist visits.  Subscribers do not need specialist referrals.

United Healthcare pays %100 of preventative care as part of this plan. This includes;  annual physicals, mammogram, cardiovascular screenings as well as certain vaccines.   Plan 2 includes; home health care, podiatry services, hearing services, vision services and also basic dental services.  The drug plan has a 5 tier copay plan with a $200 deductible for Tiers 3,4 and 5 only.

Like all other part D and MAPD drug plans in CT, there is a Coverage Gap ( donut-hole) that applies to this RX benefit.  Although it is an HMO plan, the Medicare Complete Plan 2 does offer the 2016 UHC Passport Program at no additional cost.  The Passport program provides access to doctors in other states on an in-network basis.   Although the CT plan includes Passport,  every state does not offer the Passport progam.  For an additional premium,  your coverage can include a dental benefit rider.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Also called Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement there is not a network, instead, the insured would go to any provider that accepts or participates with Original Medicare.

A 2016 Summary of benefits and 2016 application are available in the links below.   You can send applications back to us  either by email at Admin@croweandassociates.com or by fax at 203-567-6235.

Click here for a UHC Plan 2 Summary of Benefits – Connecticut

To download a UHC Plan 2 application – Connecticut Click here

Click here for a no-obligation Medicare quote.

 United Healthcare Medicare Complete Plan 3 Connecticut

United Healthcare Medicare Complete Plan 3 Connecticut is a Medicare Advantage plan with Prescription Drugs (MAPD) offered by United Healthcare Medicare. The Medicare Complete Plan 3 is an HMO plan.  UHC offers Medicare Complete Plan 3  in Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland  as well as Windham counties.  The plan has both a $0 monthly premium and an annual out of pocket max of $6,700 (Medical only). It features co-pays of $20 for primary doc visits as well as $50 for specialist visits.  If you would like coverage for a specialist visit, you will need a referral from you PCP.  Referrals are valid for the full year.  This plan provides additional benefits for vision, foot-care, hearing aids, SilverSneakers fitness program as well as NurseLine.  This plan includes basic preventative dental services.

This Plan includes Preventative care at no cost.

In additional expenses the plan covers are,  annual wellness visits, mammograms, colonoscopy and also annual gynecological exams.  Plan members pay nothing for hospice care from a Medicare-certified hospice.

The drug plan has a 5 tier copay plan with a $140 deductible for Tiers 3,4 and 5 only.  Like all other part D and MAPD drug plans in CT, there is a Coverage Gap ( donut-hole) applicable to this Rx benefit.  Although it is an HMO plan, the Medicare Complete 3 does have the 2016 UHC Passport Program which provides access to doctors in other states on an in-network basis.  Passport is not available in all states.   A dental benefit is available with this program but there is a premium for adding it.

Please note:

A Medicare Advantage Plan with Prescription Drugs (MAPD) is NOT a Medicare Supplement plan (Also called Medigap). With an MAPD plan, Medicare is not the primary or secondary insurance.  The company offering the MAPD is your primary insurance and services must be obtained through participating providers in most cases.   A Medicare Supplement plan is secondary to Original Medicare and does not include Part D prescription drug coverage.   With a Medicare Supplement, there is not a network but instead, the insured would go to any provider that accepts or participates with Original Medicare.

Both a 2016 Summary of benefits and 2016 application are available in the links below.   You can send your application back to us either by email at Admin@croweandassociates.com or by fax at 203-567-6235

Click here for a UHC Plan 3 Application – Connecticut

Click here for a UHC Plan 3 Summary of Benefits – Connecticut

Interested in a lower maximum out of pocket plan?  Click here to learn more about the United Healthcare Complete Plan 1.

Click here for a free personalized Medicare quote.