Senior Care Plus Patriot Plan (HMO)
H2960 - 009 - 0
(3.5 / 5)
Senior Care Plus Patriot Plan (HMO) is a Medicare Advantage (Part C) Plan by Senior Care Plus.
This page features plan details for 2024 Senior Care Plus Patriot Plan (HMO) H2960 – 009 – 0 available in Washoe, Carson City, Storey Counties, NV.
IMPORTANT: This page has been updated with plan and premium data for 2024.
Locations
Senior Care Plus Patriot Plan (HMO) is offered in the following locations.
Plan Overview
Senior Care Plus Patriot Plan (HMO) offers the following coverage and cost-sharing.
| Insurer: | Senior Care Plus |
| Health Plan Deductible: | $0.00 |
| MOOP: | $2,500 In-network |
| Drugs Covered: | No |
Ready to sign up for Senior Care Plus Patriot Plan (HMO) ?
Medicare Part B Give Back Benefit
The Part B Premium Reduction (Medicare Part B Give Back Benefit) lowers the cost of some Medicare Advantage plans.
Senior Care Plus Patriot Plan (HMO) qualifies for a monthly Medicare Give Back Benefit of $75.00.
| Premium Reduction: | $75.00 |
Premium Breakdown
Senior Care Plus Patriot Plan (HMO) has a monthly premium of $0.00. This amount includes your Part C premium but does not include your Part B premium.| Part B | Part C | Part B Give Back | Total |
|---|---|---|---|
| $174.70 | $0.00 | $75.00 | $99.70 |
- Your Part B premium may differ based on factors including late enrollment, income, and disability status.
Additional Benefits
Senior Care Plus Patriot Plan (HMO) also provides the following benefits.
| $0 |
| In-network | No |
| $2,500 In-network |
| No |
| In-network | No |
| $0-440 copay per visit (Authorization is required.) (Referral is required.) |
| Primary | $0-10 copay per visit (Not applicable.) (Not applicable.) |
| Specialist | $40 copay per visit (Authorization is not required.) (Referral is not required.) |
| $0 copay (Authorization is not required.) (Referral is not required.) |
| Emergency | $135 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Urgent care | $30-65 copay per visit (always covered) (Not applicable.) (Not applicable.) |
| Diagnostic tests and procedures | $0-300 copay (Authorization is not required.) (Referral is not required.) |
| Lab services | $0-120 copay (Authorization is not required.) (Referral is not required.) |
| Diagnostic radiology services (e.g., MRI) | $0-130 copay (Authorization is not required.) (Referral is required.) |
| Outpatient x-rays | $60 copay (Authorization is not required.) (Referral is required.) |
| Hearing exam | $50 copay (Authorization is not required.) (Referral is not required.) |
| Fitting/evaluation | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Hearing aids | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Oral exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Cleaning | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Fluoride treatment | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Dental x-ray(s) | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Non-routine services | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Diagnostic services | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Restorative services | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Endodontics | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Periodontics | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Extractions | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Prosthodontics, other oral/maxillofacial surgery, other services | 0% coinsurance (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Routine eye exam | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Other | Not covered (There are no limits.) (Not applicable.) (Not applicable.) |
| Contact lenses | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglasses (frames and lenses) | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglass frames | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Eyeglass lenses | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Upgrades | $0 copay (Limits may apply.) (Authorization is not required.) (Referral is not required.) |
| Occupational therapy visit | $20 copay (Authorization is required.) (Referral is not required.) |
| Physical therapy and speech and language therapy visit | $20 copay (Authorization is not required.) (Referral is not required.) |
| $250 copay (Not applicable.) (Not applicable.) |
| $0 copay (Limits may apply.) (Authorization is required.) (Referral is required.) |
| Foot exams and treatment | $40 copay (Authorization is not required.) (Referral is not required.) |
| Routine foot care | Not covered (Not applicable.) (Not applicable.) |
| Durable medical equipment (e.g., wheelchairs, oxygen) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Prosthetics (e.g., braces, artificial limbs) | 20% coinsurance per item (Authorization is required.) (Not applicable.) |
| Diabetes supplies | 0-20% coinsurance per item (Authorization is not required.) (Not applicable.) |
| Covered (Authorization is required.) (Referral is not required.) |
| Chemotherapy | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Other Part B drugs | 0-20% coinsurance (Authorization is required.) (Not applicable.) |
| Part B Insulin drugs | $35 copay (Authorization is required.) (Not applicable.) |
| Tier 1 $250 per day for days 1 through 6 $0 per day for days 7 through 90 Tier 2 $440 per day for days 1 through 5 $0 per day for days 6 through 90 (Authorization is required.) (Referral is required.) |
| Inpatient hospital – psychiatric | Tier 1 $250 per day for days 1 through 6 $0 per day for days 7 through 90 Tier 2 $440 per day for days 1 through 5 $0 per day for days 6 through 90 (Authorization is required.) (Referral is required.) |
| Outpatient group therapy visit with a psychiatrist | $40 copay (Authorization is not required.) (Referral is required.) |
| Outpatient individual therapy visit with a psychiatrist | $40 copay (Authorization is not required.) (Referral is required.) |
| Outpatient group therapy visit | $40 copay (Authorization is not required.) (Referral is not required.) |
| Outpatient individual therapy visit | $40 copay (Authorization is not required.) (Referral is not required.) |
| $20 per day for days 1 through 20 $150 per day for days 21 through 34 $0 per day for days 35 through 100 (Authorization is required.) (Referral is not required.) |
Ready to sign up for Senior Care Plus Patriot Plan (HMO) ?
Table of Contents
SMID: MULTIPLAN_HCIHNDOGMED01_M
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