AdventHealth SunSaver Plan Volusia County, FL — 2022 Medicare Advantage Plan
This page contains editorial content that is not endorsed or approved by Health First Health Plans[2]. This is not a solicitation of insurance.
Online enrollment by MedicareEnrollment.com[1].
| Medicare Rating: | |
|---|---|
| Plan ID: | H1099-016 |
| Plan Year: | 2022 |
| Premium: | $0.00/mo |
| Part B Reduction: | NONE |
| Health Plan Deductible: | NONE |
| Drug Plan Benefit: | Yes |
| Rx Deductible: | $0.00/year |
| Rx Gap Coverage: | Yes |
| Availability: | Volusia County, FL |
| Policy Valid: | 2022-1-1 to 2022-12-31 |
| Insured By: | Health First Health Plans |
AdventHealth SunSaver Plan is a 2022 Medicare Advantage HMO plan, from Health First Health Plans, that's available to Medicare beneficiaries living in Volusia County, Florida.
Key Takeaways
- It's a Health Maintenance Organization (HMO) health plan.
- It has the same coverage benefits as Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage..
- It offers additional benefits that Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Medicare Part BMedicare Part B is medical coverage for people with Original Medicare benefits. It covers doctor visits, preventative care, tests, durable medical equipment, and supplies. Medicare Part B pays 80 percent of most medically necessary healthcare services. do not include.
- There's a $0 copayment to see your primary care doctor (in-networkDoctors, hospitals, pharmacies, and other healthcare providers that agree to health plan members' services and supplies at a set price are in-network providers. With some health plans, your care is only covered if you get...).
- The monthly premium is $0.00 (plus your monthly Medicare Part B premiumThe Medicare Part B premium is the monthly charge paid by beneficiaries for their outpatient medical care, services, and supplies. A beneficiary's premium may be uplifted by an IRMAA surcharge if their income is above...).
- The health plan does not have an annual deductibleA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share..
- The maximum out-of-pocket costOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary's health insurance plan. These costs can come from the beneficiary's monthly premiums, deductibles, coinsurance, and copayments. with this plan is $5,500 (in-network).
- AdventHealth SunSaver Plan includes a Medicare Part DMedicare Part D plans are an option Medicare beneficiaries can use to get prescription drug coverage. Part D plans provide cost-sharing on covered medications in four different phases: deductible, initial coverage, coverage gap, and catastrophic. Each... plan for prescription medications. The annual Part D deductible is $0.00.
This HMO plan replaces your Part A and Part B Medicare coverage with a managed care health plan in Volusia County, Florida. If you enroll in AdventHealth SunSaver Plan you agree to let Health First Health Plans manage your Medicare benefits.
IMPORTANT: With AdventHealth SunSaver Plan you are required to use healthcare providers in the plan's network. If you don't you will incur all costs. Also, you must see your primary care physician for referrals to specialists and other healthcare providers.
Monthly Premium
AdventHealth SunSaver Plan's monthly premium in Volusia County is $0.00. That includes your prescription coverage, as well. Plus, you must continue to pay your monthly Medicare Part B premium. Some Medicare Advantage plansMedicare Advantage (MA), also known as Medicare Part C, are health plans from private insurance companies that are available to people eligible for Original Medicare (Medicare Part A and Medicare Part B). include a monthly Part B premium reduction, also known as the Medicare give back. This plan's Part B premium reduction is NONE.
Co-payments and/or co-insurances also apply with most healthcare services, except preventive care mandated by CMS (see H1099-016 Summary of Benefits).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $0.00 per year. That means you have first dollar coverage.
IMPORTANT: When evaluating AdventHealth SunSaver Plan, look past the monthly premium. Identify the costs of the healthcare services you use most. Only then will you uncover the plan's value for your personal situation.
Maximum Out-of-Pocket (MOOP) Limit
Unlike Original Medicare, Medicare Advantage plans must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The AdventHealth SunSaver Plan plan MOOP is $5,500 . Once you reach this amount of spending on your copayments, all of your Medicare Part A and Part B services will be covered at no additional charge for the remainder of the year.
NOTE: MOOP does not include what you spend on monthly premiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. . It also does not apply to your prescription drugs, Part D deductible, or any other extra benefits bundled in the plan.
CRITICAL: Be sure to evaluate the annual premiums and MOOP of AdventHealth SunSaver Plan versus what you might expect to pay for a Medicare SupplementMedicare Supplements are additional insurance policies that Medicare beneficiaries can purchase to cover the gaps in their Original Medicare (Medicare Part A and Medicare Part B) health insurance coverage. in Volusia County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage plans with a similar annual cost.
Contact Health First Health Plans
If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov. To learn more about this plan, visit the Health First Health Plans Medicare website.
Additional Medicare Plan Options in Volusia County
Are you eligible for a Volusia County, FL Medicare Special Needs Plan (SNP)? SNPs are a special type of Medicare Advantage plan designed to help people with special needs. Here are some of the SNP plans in your area:
- Freedom VIP Savings (Local HMO), for Chronic or Disabling Condition beneficiaries
- Optimum Emerald Full (Local HMO), for Dual-Eligible beneficiaries
- Wellcare Dual Medicare (Local HMO), for Dual-Eligible beneficiaries
- Optimum Diamond Rewards (Local HMO), for Chronic or Disabling Condition beneficiaries
- CareNeeds PLUS (Local HMO), for Dual-Eligible beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- FHCP Medicare Rx Plus (HMO-POS)
- Wellcare Premium Enhanced Open (PPO)
- HumanaChoice Florida H7284-006 (PPO)
- BlueMedicare Value (PPO)
- AARP Medicare Advantage Choice (PPO)
The Medicare Part C information on this page originates from CMS Landscape Source Files, is maintained by David Bynon, and was last updated on .