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Medicare Choice Benefits
Denver Health Medical Plan
Medicare Choice HMO SNP
This plan is for those who are looking for a comprehensive health plan and have both Medicare Parts A & B and full Medicaid benefits. In this plan, “Extra Help” also known as Low Income Subsidy (LIS) may pay for some or all of your
drug costs for income-qualified members. This plan is available to anyone who has both Medical Assistance from the State and Medicare.Medicare Select Benefits
Denver Health Medical Plan
Medicare Select HMO
This plan is for those who are looking for a comprehensive health plan and have Medicare Parts A & B. In this plan, “Extra Help” also known as Low Income Subsidy (LIS) may pay for some or all of your prescription drug costs.Extra 2018 Choice Benefits Include
- Dental coverage: up to $1,500 in comprehensive dental services with $0 copay
- Vision coverage: up to $500 in eyewear
- Hearing aids: up to $1,500 in coverage every 3 years
- $0 cost annual Denver Parks and Recreation membership
- $0 cost non-emergency medical transportation – 25 round trips
- Home delivered meals to support your recovery following discharge from hospital or skilled nursing facility
Part D Prescription Drug Premium $34.20
(may be paid by "Extra Help")Pharmacy Benefits
- Deductible $405
Copay during initial coverage stage:
Generic Drugs (including brand drugs treated as generic) either $0 copay / $1.25 copay / $3.35 copay / or 25% of total cost
For all other drugs either $0 copay / $3.70 copay / $8.25 copay / or 25% of total cost
- Premiums, copays, coinsurance and deductibles may vary based on the level of “Extra Help” that beneficiaries may receive. Please contact a plan representative for further details
- In general, plan members must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances; quantity limitations and restrictions may apply
Extra 2018 Select Benefits Include
- $0 copay for preventive dental services
- Vision coverage: up to $350 in eyewear
- Hearing aids: up to $1,500 in coverage every 3 years
- $0 cost annual Denver Parks and Recreation membership
- $0 cost non-emergency medical transportation – 25 round trips
- Maximum out-of-pocket of $5,500 (The most you will pay in a year for Medicare-covered Part A and B services)
Part D Prescription Drug Premium $34.20
(may be paid by "Extra Help")Pharmacy Benefits
- Deductible $355
- No Part D deductible on Tier 1 medications and a low $3.50 copay
- No part D deductible on Tier 6 medications and a $0 copay
- Set copays for Tiers 1, 2
- Percentage copays for Tiers 3-5
- Premiums, copays, coinsurance and deductibles may vary based on the level of “Extra Help” that beneficiaries may receive. Please contact a plan representative for further details
- In general, plan members must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances; quantity limitations and restrictions may apply
