Senior Care Plus Patriot Plan (HMO) 2024 Benefit Details for Plan H2960-009-0 by Senior Care Plus
Senior Care Plus Patriot Plan is a 2024 HMO Medicare Advantage plan {with_without_pdp} Part D.
This Senior Care Plus option offers the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may also include additional, valuable benefits not covered by Part A or Part B.
Plan Basics | |
---|---|
Plan ID: | H2960 009 0 |
Plan Type: | Local HMO |
Plan Year: | 2024 |
Premium: | $0.00/mo Plus your Medicare Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | $2,500/yr |
Part B Reduction: | $75.00/mo |
Drug Plan Benefit: | Not Included |
Rx Gap Coverage: | No |
Supplemental Benefits: | Dental, Vision, Hearing |
Availability: | See List |
Insured By: | Senior Care Plus |
Summary of Benefits |
---|
Health Plan Cost Sharing
This Senior Care Plus Medicare Advantage plan has cost-sharing. These are costs you must pay out-of-pocket when you use approved health services.
NOTE: Most preventive services are covered 100% by the plan as a Part B benefit.
The following table summarizes the most common out-of-pocket costs you will incur if you join this plan unless you go out-of-network:
Healthcare Service | Member Cost |
---|---|
Doctor Visits (In-Network) | |
Primary: | $10 Copay |
Specialist: | $40 Copay |
Wellness programs (e.g., fitness, nursing hotline): | None |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $40 Copay |
Routine foot care: | Not Covered |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $20 Copay |
Routine chiropractic care: | Not Covered |
Emergency Care / Urgent Care | |
Emergency room care: | $135 Copay |
Urgent care: | $65 Copay |
Ground ambulance: | $250 Copay |
Inpatient hospital coverage: | $250.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient hospital coverage: | $440 Copay Authorization Required, Referral Required |
Skilled Nursing Facility: | $20.00 per day for days 1 through 20 $150.00 per day for days 21 through 34 $0.00 per day for days 35 and beyond |
Optional supplemental benefits: | |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $40 Copay |
Outpatient group therapy visit with a psychiatrist: | $40 Copay |
Inpatient hospital - psychiatric: | $250.00 per day for days 1 through 6 $0.00 per day for days 7 and beyond |
Outpatient group therapy visit: | $40 Copay |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $20 Copay |
Occupational therapy visit: | $20 Copay Authorization Required |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | 20% Coinsurance |
Durable medical equipment (e.g., wheelchairs, oxygen): | 20% Coinsurance Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 20% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | $130 Copay Referral Required |
Lab services: | $120 Copay |
Outpatient x-rays: | $60 Copay Referral Required |
Diagnostic tests and procedures: | $300 Copay |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | 20% Coinsurance |
Other Part B drugs (Medicare-covered) | 20% Coinsurance |
Feel free to download our Senior Care Plus Patriot Plan Summary of Benefits information.
Supplemental Benefits
The following is a summary of the supplemental benefits Senior Care Plus includes with this plan:
Supplemental Healthcare Service | Member Cost |
---|---|
Preventive Dental | Maximum dental benefit: | Non Specified |
Oral exam (In-Network) | Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Covered |
Cleaning (In-Network) | Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Covered |
Extractions (In-Network) | Covered |
Endodontics (In-Network) | Covered |
Restorative services (In-Network) | Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Covered |
Hearing Aids | |
Fitting/evaluation (In-Network) | Covered Limits may apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | $0 Copay |
Vision | Maximum vision benefit: | $250.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | Covered Limits may apply |
Routine eye exam (In-Network) | $0 Copay |
Contact lenses (In-Network) | Covered Limits may apply |
Additional Benefits
None specified.
Prescription Drug Plan Costs & Benefits
This plan does not include a Medicare Part D plan for prescriptions.
CMS Rating Marks for 2024
Each year Medicare rates health plans (Part C) and drug plans (Part D) in several major categories based on a 5-star rating system. These ratings are designed to help you understand the quality of care and service you can expect if you join this Senior Care Plus plan.
CMS Measure | Star Rating |
---|---|
2024 Overall Rating | |
Staying Healthy: Screenings, Tests, Vaccines | |
Managing Chronic (Long Term) Conditions | |
Member Experience with Health Plan | |
Complaints and Changes in Plans Performance | |
Health Plan Customer Service | |
Drug Plan Customer Service | |
Complaints and Changes in the Drug Plan | |
Member Experience with the Drug Plan | |
Drug Safety and Accuracy of Drug Pricing |
This Medicare Advantage HMO plan is way better than average. Here's how we can make this claim. Senior Care Plus Patriot Plan does an excellent job keeping its members healthy through its preventive care program with proactive screenings, tests, and vaccines. This plan is good at managing its member's chronic (long-term) health conditions.
Medicare beneficiaries enrolled in this Senior Care Plus plan enjoy a good member experience. Complaints and changes in plan performance are one way we can measure quality, and this plan scores good at both. Not the best or the worst when it comes to customer service, this health plan's customer service is average.
If you're looking for more value, this plan offers dental, vision, and hearing benefits (limitations may apply) that are not included with Original Medicare.
With no additional monthly premium, this plan can save you money if you're healthy. Members will love the Part B Giveback benefit. It's $75.00 per month. We love it when we see a plan with a maximum out-of-pocket (MOOP) limit less than $3,000, and this plan brings it in at $2,500 per year. The MOOP does not include prescriptions, but the good news is that a 5-day stay in the hospital with Senior Care Plus Patriot Plan will probably cost less than Original Medicare. With no annual deductible, members of this health plan have first dollar coverage, which is comforting on a fixed budget.
Plan Availability
Senior Care Plus Patriot Plan (H2960-009-0) is available in the following locations (click to open):
Additional Medicare Advantage Plan Options
The Medicare Advantage program offers a myriad of options, including these plans:
- H2960-018-0: Senior Care Plus Select Plan (HMO)
- H2960-023-0: Renown Preferred Plan by Senior Care Plus (HMO)
- H2960-019-0: Senior Care Plus Complete Plan (HMO)
- H2960-009-0: Senior Care Plus Patriot Plan (HMO)
- H2960-012-0: Senior Care Plus Essential plan (HMO)
Contact Senior Care Plus
Plan Website: | http://www.SeniorCarePlus.com |
---|---|
Formulary Information: | http://www.SeniorCarePlus.com |
Pharmacy Information: | Senior Care Plus Pharmacy Page |
Prospective Members: | (888)775-7003 |
TTY Users: | 711 |
If you qualify for Medicare benefits 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.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, GlobalHealth, Health Care Service Corporation, Cigna Healthcare, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Scott and White Health Plan now part of Baylor Scott & White Health, UnitedHealthcare(R), and Wellcare.
Citations & References
- Senior Care Plus, http://www.SeniorCarePlus.com, Last Accessed February 20, 2024
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed January 21, 2024
- Medicare.gov, "Your Medicare coverage choices", Last Accessed February 19, 2024
- Medicare.gov, "Medicare & You in Different Formats", Last Accessed February 19, 2024
- Medicare.gov, "Your Medicare Coverage", Last Accessed April 11, 2023
- CMS.gov, Landscape Source Files, Last Accessed February 21, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed February 21, 2024
- CMS.gov, Plan Benefits Package, Last Accessed February 21, 2024
About This H2960-009-0 Plan Detail Page
The data on this Senior Care Plus Patriot Plan plan detail page is derived from the 2024 Landscape Source Files, Plan Benefit Package, and Medicare Part C and Part D Performance Data published by CMS.
The author interprets these files, and their associated data dictionary, with great care, making every attempt to communicate the data submitted by Senior Care Plus to CMS as clearly and accurately as possible. Given the complexity of the data, the author recommends that all potential enrollees request an official Summary of Benefits from Senior Care Plus, at (888)775-7003, prior to enrollment.