WellCare Today's Options Premier 200 is a Medicare Advantage plan, from WellCare, that's available to Medicare beneficiaries living in Herkimer County, New York. This is a Private Fee-for-Service (PFFS) health plan option.
- It's a Private Fee-for-Service (PFFS) health plan.
- It has the same coverage benefits as Original 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 may offer extra benefits that Medicare Part A is hospital inpatient coverage for people with Original Medicare, whereas Part B is medical coverage for doctor visits, tests, etc.... and Medicare Part B is medical coverage for people with Original Medicare. It covers doctor visits, specialists, lab tests and diagnostics, and durable medical equipment. Part A is for hospital inpatient care.... do not include.
- There's a $0 copay to see your primary care doctor (in-network).
- The monthly premium is $71.00 (plus your monthly Medicare Part B premium).
- There is no annual A deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share.... on the health plan.
- The maximum Out-of-pocket costs (aka, out-of-pocket medical expenses) are costs that a beneficiary must pay because their health insurance does not cover them. Out-of-pocket costs are found in the deductibles, copayments, and coinsurance outlined in each health... with this plan is $- (in-network).
PFFS plans appear similar to Original Medicare and Medigap, but they are different. Specifically, the plan determines how much it will pay doctors, other health care providers, and hospitals, and how much you must pay when you use healthcare services. That means you can use any physician or specialist you like, so long as they agree to the plan's payment terms. They can also choose not to treat you, unless it's an emergency, if they don't accept the payment terms. Check with your primary care doctor and specialists before you enroll.
NOTE: WellCare Today's Options Premier 200 does not include a drug plan for prescription coverage. To get it, you can add one of the stand-alone Medicare Prescription Drug Plans available in New York.
WellCare Today's Options Premier 200 Cost Details
WellCare Today's Options Premier 200's monthly premium in Herkimer County is $71.00. Plus, you must continue to pay your monthly Medicare Part B premium.
The plan's monthly premium plus your monthly Medicare Part B premium is the total cost most people pay to be in this plan. You will pay this amount monthly even if you don't use healthcare services. Most healthcare services, except your annual wellness exam, will have their own copays or Coinsurance is a percentage of the total you are required to pay for a medical service. ... costs.
IMPORTANT: When evaluating WellCare Today's Options Premier 200, look at more than just the monthly premium. Identify the shared costs of the healthcare services you use most. Only then will you know if the plan is appropriate for you and your personal health and financial situation.
A deductible is an amount you pay out of pocket before the plan begins paying its share. This Medicare Advantage plan does not include a Medicare prescription drug plan (Part D) so only a health plan deductible applies.
The health plan deductible with WellCare Today's Options Premier 200 is NONE.
Most health services provided by WellCare Today's Options Premier 200 have a copayment or coinsurance that you must pay out-of-pocket when you receive the service. Copays for the most common health services are outlined in this table.
Maximum Out-of-Pocket (MOOP) Limit
Unlike Original Medicare, Medicare 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).... must set an annual Maximum Out-of-Pocket limit on inpatient and outpatient healthcare services. The WellCare Today's Options Premier 200 plan MOOP is $- . Once you reach this amount of spending on your A copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service...., 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 A 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 WellCare Today's Options Premier 200 versus what you might expect to pay for a Medicare 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 Herkimer County. Some Medicare Supplements offer less overall financial risk than Medicare Advantage plans with a similar annual cost.
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 WellCare Medicare website.
Additional Medicare Plan Options in Herkimer County
Are you eligible for a Herkimer County, NY 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:
- UnitedHealthcare Dual Complete (Local HMO), for Dual-Eligible beneficiaries
- Aetna Medicare Assure Plan (Local HMO), for Dual-Eligible beneficiaries
- UnitedHealthcare Nursing Home Plan 1 (Local PPO), for Institutional beneficiaries
- Fidelis Dual Advantage (Local HMO), for Dual-Eligible beneficiaries
- Fidelis Dual Advantage Flex (Local HMO), for Dual-Eligible beneficiaries
Not qualified for an SNP? Here are some additional plans you might consider:
- MVP Medicare Preferred Gold with Part D (HMO-POS)
- UnitedHealthcare Medicare Advantage Patriot (PPO)
- Medicare BlueClassic (PPO)
- UnitedHealthcare Medicare Advantage Choice Plan 4 (PPO)
- MVP Medicare Preferred Gold without Part D (HMO-POS)