Outpatient x-rays: 0% or 20% coinsurance (authorization required).

Diagnostic radiology services (e.g., MRI): 0% or 20% coinsurance (authorization required).

Lab services: $0 copay (authorization required).

Diagnostic tests and procedures: 0% or 20% coinsurance (authorization required).

Specialist: 0% or 20% coinsurance per visitĭiagnostic procedures/lab services/imaging.

Primary: 0% or 20% coinsurance per visit.

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Īdditional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

Drug plan deductible: $445.00 annual deductible.

Other health plan deductibles: In-network: No.

You must continue to pay your Part B premium.

Total Monthly Premium with LIS (Parts C & D): Monthly Premium with Extra Help Low-Income Subsidy (LIS): ❔ The Monthly Premium is Split as Follows: ❔ Number of Members enrolled in this plan in (H9455 - 001): Number of Members enrolled in this plan in Tooele, Utah: See cost-sharing for all pharmacies and tiers.

No additional gap coverage, only the Donut Hole Discountīrowse the Steward Health Choice Generations (HMO D-SNP) Formulary $0 for people who qualify for both Medicare and Medicaid. $0.00 for people who qualify for both Medicare and Medicaid. Or contact your local SHIP for assistanceĮmail a copy of the Steward Health Choice Generations (HMO D-SNP) benefit details Please go to or call 1-800-MEDICARE (1-80) to get information on all of your options. Ĭlick here to see plans for the current plan year This plan information is for research purposes only. Tooele, Utah Click to see other locations Steward Health Choice Generations (HMO D-SNP) 2021 Medicare Advantage Plan Benefit Details.2021 Medicare Prescription Drug Plan (PDP) Benefit Details.2021 PDP-Planner & Donut Hole Calculator.Search for 2021 Medicare Plans by Formulary ID.Search for 2021 Medicare Plans by Plan ID.Guided Help Finding a 2021 Medicare Prescription Drug Plan.2021 Part D Plan (PDP) Overview by State.Q1Rx 2021 Medicare Part D or Medicare Advantage Plan Finder by Drug.Browse Any 2021 Medicare Plan Formulary (Drug List).

2021 Medicare Advantage Plans (Health and Health w/Rx Plans).Find a 2021 Medicare Part D Plan (PDP-Finder: Rx Only).MA-Compare: Review Changes in each 2020 Medicare Advantage Plan for 2021.PDP-Compare: How will each 2020 Part D Plan Change in 2021?.Find a 2024 Medicare Advantage Plan by Drug Costs.2024 Medicare Advantage Plan Benefit Details.2024 Medicare Advantage Plans State Overview.IRMAA: Higher premiums for higher incomes.Understanding Your Explanation of Benefits.Medicare plan quality and CMS Star Ratings.Q1Rx Drug-Finder: Compare Drug Cost Across all 2024 Medicare Plans.Browse Any 2024 Medicare Plan Formulary (or Drug List).Find a 2024 Medicare Advantage Plan (Health and Health w/Rx Plans).

Steward health choice generations utah