Enrollment in a PHP Advantage plan may be limited to specific times of the year. You must continue to pay your Medicare Part B premium. To enroll in a PHP Advantage plan, you must have both Medicare Parts A and B and reside in the plan service area. All PHP Advantage plans include Part D drug coverage. Enrollment in PHP Advantage depends on contract renewal. PHP Advantage is an HMO-POS plan with a Medicare contract. Please leave a message, and your call will be returned the next business day. You may reach a messaging service on weekends from April 1 through Sept. SilverSneakers ® is a fun, energizing program that helps people with Medicare take greater control of their health by encouraging physical activity and offering social events.and it includes a fitness center membership to any participating location across the country at no extra cost to you!Įmergency or urgent care coverage if you are making a trip out of state or countryĢ8 meals (2 meals/day for 14 days) delivered to your home after discharge from inpatient acute care or a skilled nursing facility (limit 2 discharges annually)Įxtra benefit expenses are not covered under the maximum out-of-pocket limit. SilverSneakers ® Fitness Benefits (What’s this?) Attention PHP Advantage wants to help you achieve and maintain long-lasting health and wellness. $0 Copay for 20 one-way trips to approved locations per year $1,000 allowance for up to 2 hearing aids every 2 years (both ears combined) $45 per quarter up to 2 orders per quarter no rollover $0 Copay for a pair of eyeglass frames or contact lenses ( 2 six packs) Your PHP Advantage plan offers many valuable extras not offered by Original Medicare or Medicare supplement plans–at no additional cost to you. See the Evidence of Coverage for more information regarding Select Insulins, including full cost-sharing information. For information regarding which insulins are Select Insulins under the plan’s benefit, refer to the plan’s Prescription Drug Formulary. *Select Insulins are those that are part of the Insulin Savings Program and therefore will incur low, consistent copays through the coverage gap. A drug formulary provides a list of drugs that are covered by our plan. This table shows the drug tiers associated with your plan, and the copayments or co-insurance that you will pay in each tier. *See Evidence of Coverage for more details. Outpatient Surgery at Ambulatory Surgical Center No referrals for in-network specialist visits!* If you reach this limit, you will no longer have to pay any copays or co-insurance. Maximum Out-of-Pocket Limit (What’s this?) Attention This means you will never pay more than $3,800 per year for covered medical expenses, even if you have an unexpected illness or injury.
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