Cherry Blossom PACE – Dual Eligible (PACE) is a Medicare Advantage PACE plan by Cherry Blossom PACE.
IMPORTANT: Cherry Blossom PACE – Dual Eligible (PACE) is a PACE plan. Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid program for people who are 55 or older, live in the service area of a PACE organization, need a nursing home-level of care (as certified by your state), and are able to live safely in the community with help from PACE.
This page features plan details for 2023 Cherry Blossom PACE – Dual Eligible (PACE) H3991 – 001 – 0.
IMPORTANT: This page features the 2023 version of this plan. See the 2025 version using the link below:
Cherry Blossom PACE – Dual Eligible (PACE) is offered in the following locations.
Cherry Blossom PACE – Dual Eligible (PACE) offers the following coverage and cost-sharing.
| Special Needs Plan Type: | National PACE |
| Conditions Covered: |
| Insurer: | Cherry Blossom PACE |
| Health Plan Deductible: | $0.00 |
| MOOP: | |
| Drugs Covered: | Yes |
Ready to sign up for Cherry Blossom PACE – Dual Eligible (PACE) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST
| Part B | Part C | Part D | Part B Give Back | Total |
|---|---|---|---|---|
| $164.90 | $0.00 | $356.80 | $0.00 | $ |
Cherry Blossom PACE – Dual Eligible (PACE) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
| Drug Deductible: | $ |
| Initial Coverage Limit: | $ |
| Catastrophic Coverage Limit: | $7,400.00 |
| Drug Benefit Type: | |
| Gap Coverage: | |
| Formulary Link: | Formulary Link |
| Part D | LIS 25% | LIS 50% | LIS 75% | LIS Full |
|---|---|---|---|---|
| $356.80 | $43.40 | $34.80 | $26.30 | $17.70 |
After you pay your $ drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $. Once you reach that amount, you will enter the next coverage phase.
| Tier | Cost |
|---|---|
| All other tiers (Generic) | 25% |
| All other tiers (Brand-name) | 25% |
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.
| Tier | Cost |
|---|---|
| Generic | $4.15 copay or 5% (whichever costs more) |
| Brand-name | $10.35 copay or 5% (whichever costs more) |
Ready to sign up for Cherry Blossom PACE – Dual Eligible (PACE) ?
Get help from a licensed insurance agent.
Call 1-877-354-4611 / TTY 711.
M-F: 8:00 am – 10:00 pm EST
Sat-Sun: 8:00 am – 9:00 pm EST