Lasso Healthcare is a 2020 Medicare Advantage plan from Lasso Healthcare that's available in Berks County, Pennsylvania. It's a Medical Savings Account (MSA) plan for people with Medicare Part A and Part B benefits. It does not include prescription drug benefits (no Part D).
MSA plans have two distinct components. The first component is high-deductible health insurance that does not assist you with the cost of your healthcare services until your out-of-pocket spending reaches the annual deductible. The second component is a medical savings account into which Medicare deposits money you can use to help pay for your healthcare. You can use money from the savings account to pay your health care costs before you meet the deductible.
You have complete freedom to choose the doctors, hospitals and other healthcare providers you use, so long as they accept Medicare payment, the plan's terms and conditions for payment, and agree to treat you.
In addition to the monthly premium, you pay all costs until the deductible is met, then the plan kicks in to pay its share. Members get all of the benefits covered by Original Medicare. For some of these benefits, you may pay more.
These are the areas of the plan that are important to compare and review:
- Premium: This is the amount you will pay monthly, above and beyond your Medicare Part B.
- Maximum-Out-Of-Pocket (MOOP): This is the most you will pay for co-pays and co-insurance before the plan pays 100%.
- CMS Ratings: Important measurements across 5 different areas that will help you understand how well this plan will care for you.
- Prescription Coverage: Not included with this plan.
- Co-pays & Co-insurance: If you see the doctor regularly, including specialists, you need to know what you'll pay for each visit.
NOTE: Medicare will deposit $2,000 into your MSA savings account. For members who join after January 1, this amount will be adjusted (pro-rated) for the number of months remaining in the year.
IMPORTANT: If you're considering Lasso Healthcare but the high deductible scares you, understand that money spent for Medicare-covered services counts toward your plan's deductible. When you reach the out-of-pocket limit, the MSA plan pays your Medicare-approved healthcare costs in full. Plus, money in your account rolls over, year after year. It's not lost.
NOTE: This plan does not include prescription drug coverage. To get it, you can add one of the stand-alone Medicare Part D plans available in Pennsylvania.
How Much Does Lasso Healthcare Cost?
The premium on this plan is $50.00 per month. Plus, you must continue to pay your monthly Medicare Part B premium. Co-payments and/or co-insurances also apply with most healthcare services, except preventative care mandated by CMS (see H1924-002 Summary of Benefits below).
IMPORTANT: When evaluating this 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.
What is the 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 Lasso Healthcare plan MOOP is $- . Once you reach this amount of spending on your co-payments, all of your Medicare Part A and Part B services will be covered at no additional charge.
Plans can set their MOOP at a voluntary level of $0 to $3,400 (for in-network services) or a mandatory $3,401 to $6,700 (in-network). Combined totals for in-network and out-of-network are generally higher.
NOTE: MOOP does not include what you spend on monthly premiums. It also does not apply to your prescription drugs or Part D deductible.
CRITICAL: It is important to evaluate the combined annual MA/MAPD premiums and MOOP versus what you might expect to pay for a Medicare Supplement in Berks County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage.
Lasso Healthcare is a new plan for 2020. As such it has not been rated by CMS.
NOTE: Many new plans enter the market with low premiums and low co-pays. Remember, it's important to evaluate plans every year. This is particularly true with new plans.
Does Lasso Healthcare include Medicare Part D?
This plan does not include prescription drug coverage. You can get prescription coverage by joining one of the Medicare Part D Plans in Pennsylvania.
How Much are the Copays & Co-Insurance?
In this Summary of Benefits section we outline high-level information about the plan's co-payment and co-insurance costs for inpatient, outpatient, preventive care, transportation and other healthcare services. For complete details or assistance call: 1-855-266-4865.
Lasso Healthcare vs. Medigap
To compare Lasso Healthcare with a Medigap plan (Medicare supplemental insurance), you need to evaluate your healthcare and financial needs. Look at the total potential cost with each plan type, not just the monthly premium, and choose how you want to use medical care (locally or nationally).
To help you make a better decision, we created our How-to Choose the Best Medicare Plan guide. It will help you understand how to compare Lasso Healthcare with Medicare Supplement plans in Pennsylvania. Medicare Plan F in Pennsylvania is the most popular.
Contact Lasso Healthcare
For more information about this plan, call the Enrollment Assistance line, or visit the Enrollment Website or the plan website:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. 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 Lasso Healthcare Medicare website.
Additional Medicare Plan Options in Berks County
Are you eligible for a Berks County, PA 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:
- Health Partners Medicare Special (Local HMO), for Dual-Eligible beneficiaries
- BlueJourney Alliance Lung Care (Local HMO), for Chronic or Disabling Condition beneficiaries
- AmeriHealth Caritas VIP Care (Local HMO), for Dual-Eligible beneficiaries
- BlueJourney Alliance Heart and Diabetes Care (Local HMO), for Chronic or Disabling Condition beneficiaries
- UnitedHealthcare Nursing Home Plan 2 (Local PPO), for Institutional beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- Humana Honor (PPO)
- Aetna Medicare Value (PPO)
- BlueJourney Prime (PPO)
- Geisinger Gold Classic Complete Rx (HMO)
- BlueJourney Value (HMO)
Lasso Healthcare is available to Medicare beneficiaries living in Hereford, Bally, Barto, Bechtelsville, Bernville, Bethel, Birdsboro, Blandon, Bowers, Boyertown, Centerport, Douglassville, Earlville, Fleetwood, Geigertown, Hamburg, Kempton, Kutztown, Leesport, Lenhartsville, Limekiln, Lyon Station, Maxatawny, Mertztown, Mohnton, Mohrsville, Monocacy Station, Morgantown, Mount Aetna, New Berlinville, Oley, Pine Forge, Rehrersburg, Robesonia, Shartlesville, Shoemakersville, Strausstown, Temple, Topton, Virginville, Wernersville, Womelsdorf, Reading, and all other areas of Berks County, Pennsylvania; Medicare plans are the same throughout the County.