Zing Essential Wellness IL (HMO C-SNP)

H4624 - 010 - 0
Plan Not Rated

Zing Essential Wellness IL (HMO C-SNP) is a Medicare Advantage Special Needs Plan by Zing Health.

This page features plan details for 2022 Zing Essential Wellness IL (HMO C-SNP) H4624 – 010 – 0 available in Cook, Kane & Will Counties & Rockford Area.

IMPORTANT: This page features the 2022 version of this plan. See the 2025 version using the link below:

Locations

Zing Essential Wellness IL (HMO C-SNP) is offered in the following locations.

Plan Overview

Zing Essential Wellness IL (HMO C-SNP) offers the following coverage and cost-sharing.

Special Needs Plan Type:Chronic or Disabling Condition
Conditions Covered:
Insurer:Zing Health
Health Plan Deductible:$0
MOOP:$3,450 In-network
Drugs Covered:Yes

Ready to sign up for Zing Essential Wellness IL (HMO C-SNP) ?

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

Premium Breakdown

Zing Essential Wellness IL (HMO C-SNP) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$170.10 $0.00 $0.00 $0.00 $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

Zing Essential Wellness IL (HMO C-SNP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $0.00
Initial Coverage Limit: $4,430.00
Catastrophic Coverage Limit: $7,050.00
Drug Benefit Type: Enhanced
Gap Coverage: Some Generics and Few Brands
Formulary Link: Formulary Link

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs. The table below shows how the LIS impacts the Part D premium of this plan.
Part D LIS 25% LIS 50% LIS 75% LIS Full
$0.00 $0.00 $0.00 $0.00 $0.00

Initial Coverage Phase

After you pay your $0.00 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 $4,430.00. Once you reach that amount, you will enter the next coverage phase.

Gap Coverage Phase

Tier Cost
All other tiers (Generic)25%
All other tiers (Brand-name)25%

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,050.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

TierCost
Generic$4.15 copay or 5% (whichever costs more)
Brand-name$10.35 copay or 5% (whichever costs more)

Additional Benefits

Zing Essential Wellness IL (HMO C-SNP) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

In-Network: No

Dental (comprehensive)

Diagnostic services: $0 copay (limits may apply)
Endodontics: $0 copay (limits may apply)
Extractions: $0 copay (limits may apply)
Non-routine services: $0 copay (limits may apply)
Periodontics: $0 copay (limits may apply)
Prosthodontics, other oral/maxillofacial surgery, other services: $0 copay (limits may apply)
Restorative services: $0 copay (limits may apply)

Dental (preventive)

Cleaning: Covered under office visit (limits may apply)
Dental x-ray(s): Covered under office visit (limits may apply)
Fluoride treatment: Covered under office visit (limits may apply)
Office visit: $0.00
Oral exam: Covered under office visit (limits may apply)

Diagnostic procedures/lab services/imaging

Diagnostic radiology services (e.g., MRI): $50-150 copay (authorization required)
Diagnostic tests and procedures: $25 copay
Lab services: $0 copay
Outpatient x-rays: $0 copay (authorization required)

Doctor visits

Primary: $0 copay
Specialist: $20 copay per visit

Emergency care/Urgent care

Emergency: $120 copay per visit (always covered)
Urgent care: $10 copay per visit (always covered)

Foot care (podiatry services)

Foot exams and treatment: $20 copay
Routine foot care: $0 copay (limits may apply)

Ground ambulance

$175 copay

Health plan deductible

$0.00

Health plan deductibles (other)

In-Network: No

Hearing

Fitting/evaluation: $0 copay (limits may apply)
Hearing aids – inner ear: $0 copay (limits may apply)
Hearing aids – outer ear: $0 copay (limits may apply)
Hearing aids – over the ear: $0 copay (limits may apply)
Hearing exam: $20 copay

Hospital coverage (inpatient)

$250 per day for days 1 through 6
$0 per day for days 7 through 90 (authorization required)

Hospital coverage (outpatient)

$300 copay per visit (authorization required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

$3,450 In-network

Medical equipment/supplies

Diabetes supplies: 0-20% coinsurance per item
Durable medical equipment (e.g., wheelchairs, oxygen): 20% coinsurance per item (authorization required)
Prosthetics (e.g., braces, artificial limbs): 20% coinsurance per item (authorization required)

Medicare Part B drugs

Chemotherapy: 20% coinsurance (authorization required)
Other Part B drugs: 20% coinsurance (authorization required)

Mental health services

Inpatient hospital – psychiatric: $250 per day for days 1 through 6
$0 per day for days 7 through 90 (authorization required)
Outpatient group therapy visit with a psychiatrist: $20 copay
Outpatient group therapy visit: $20 copay
Outpatient individual therapy visit with a psychiatrist: $20 copay
Outpatient individual therapy visit: $20 copay

Optional supplemental benefits

No

Preventive care

$0 copay

Rehabilitation services

Occupational therapy visit: $20 copay (authorization required)
Physical therapy and speech and language therapy visit: $20 copay (authorization required)

Skilled Nursing Facility

$0 per day for days 1 through 20
$188 per day for days 21 through 100 (authorization required)

Transportation

$0 copay (limits may apply)

Vision

Contact lenses: $0 copay (limits may apply)
Eyeglass frames: $0 copay (limits may apply)
Eyeglass lenses: $0 copay (limits may apply)
Eyeglasses (frames and lenses): $0 copay (limits may apply)
Other: Not covered
Routine eye exam: $0 copay (limits may apply)
Upgrades: Not covered

Wellness programs (e.g., fitness, nursing hotline)

Covered

Ready to sign up for Zing Essential Wellness IL (HMO C-SNP) ?

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

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