On this page we help consumers: Compare Allwell Dual Medicare with other Medicare Special Needs Plans available in Berks County, Pennsylvania. This is a Local HMO plan for Dual-Eligible beneficiaries, that includes prescriptions (Part D), with a $34.00/mo premium.
What is Allwell Dual Medicare (Local HMO D-SNP)?
Allwell Dual Medicare is a 2020 D-SNP Medicare Special Needs Plan, from Allwell, available in Berks County, Pennsylvania.
- It's a Local HMO health plan.
- It includes prescription drug coverage (Medicare Part D).
- It offers the same health insurance benefits as Original Medicare.
- It offers extras that Medicare does not cover.
- Most of the costs of joining this Medicare Special Needs Plan will be covered for you.
How to Qualify to Enroll in Allwell Dual Medicare
If you qualify and enroll, this Local HMO plan replaces your Original Medicare coverage. To qualify, you must meet the following criteria:
- You have Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance).
- You live in the plan's service area.
- You have both Medicare and Medicaid.
If you're not sure if you qualify for both Medicare and Medicaid, contact your local Medicaid office.
IMPORTANT: If you qualify for this plan based on your dual eligibility status, but you also have one or more chronic conditions, you should also investigate C-SNP plans in your areas, as they may offer a care manager to help coordinate your healthcare needs.
If you don't qualify to join this plan, you might want to compare Medicare Advantage plans in Berks County, Pennsylvania. Another popular option is to add a Pennsylvania Medicare supplement plan and a stand-alone Pennsylvania Medicare prescription drug plan.
Before Joining Allwell Dual Medicare, Consider These Questions:
- Does the plan coordinate my Medicare and Medicaid benefits to make them easily accessible?
- What costs should I expect for my coverage (premiums, deductibles, copayments)?
- Is there an annual limit on my out-of-pocket expenses?
- Will I be able to use my doctors? Are they in the plan's network?
- Are the plan's in-network providers and facilities in convenient locations?
- Does the plan provide coverage for services I receive from out-of-network providers?
- Do I need a referral to see a specialist?
- Are my medications on the plan's formulary?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
How Much Does Allwell Dual Medicare Cost?
The premium on this plan is $34.00 per month. That includes your prescription drugs, as well. 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 preventive care mandated by CMS (see H2915-007 Summary of Benefits below).
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $435.00 per year. That means you pay 100% of your prescription costs until you've spent $435.00, then the plan will begin paying it's share.
Allwell Dual Medicare 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.
Allwell Dual Medicare Medicare Part D Co-Pays
This SNP plan includes prescription drug coverage (Medicare Part D). If you have regular prescriptions, it's critical that you evaluate your costs using the plan's formulary.
In addition to the monthly premium and Part D deductible, the drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the drug coverage schedule for this plan:
How Much are the Copays & Co-Insurance?
Co-pay data coming soon. For assistance call: 1-855-266-4865.
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 or the Wikipedia page. To learn more about this plan, visit the Allwell Medicare website.
Medicare Part C Plan Availability
Allwell Dual Medicare is available to 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.