Bright Advantage Harmony Choice Plan Medicare Special Needs Plan
for Maricopa County, AZ
This page contains editorial content that is not endorsed or approved by Bright HealthCare[2]. This is not a solicitation of insurance.
| Medicare Rating: | |
|---|---|
| CMS Plan ID: | H4853-018 |
| CMS Plan Year: | 2022 |
| SNP Plan Type: | Local HMO |
| Qualification: | Chronic or Disabling Condition |
| Premium: | $40.00/mo |
| Premium Valid: | Until 2022-12-31 |
| Rx Deductible: | $480.00/year |
| Rx Gap Coverage: | Some Generics |
| Availability: | Maricopa County, AZ |
| Policy Valid: | 2022-1-1 to 2022-12-31 |
| Insured By: | Bright HealthCare |
Bright Advantage Harmony Choice Plan is a 2022 C-SNP Medicare Special Needs Plan, from Bright HealthCare, available in Maricopa County, Arizona.
Key Takeaways
- It's a Local HMO health plan.
- It includes prescription drug coverage (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...).
- It offers the same basic health insurance 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 helps coordinate care for chronic conditions.
- It offers extras 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 cover.
- Most of the costs (e.g., 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. , deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., copaymentsA copayment, also known as a copay, is a set dollar amount you are required to pay for a medical service.) to be in this Medicare Special Needs Plan will be covered for you.
How to Qualify to Enroll in Bright Advantage Harmony Choice Plan
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 one or more of these severe or disabling chronic conditions:
- Chronic alcohol and other dependence
- Autoimmune disorders
- Cancer (excluding pre-cancer conditions)
- Cardiovascular disorders
- Chronic heart failure
- Dementia
- Diabetes mellitus
- End-stage liver disease
- End-Stage Renal DiseaseEnd-Stage Renal Disease (ESRD), also known as kidney failure, is a condition that causes you to need dialysis or a kidney transplant. People with ESRD are eligible for Medicare coverage regardless of age. (ESRD) requiring dialysis (any mode of dialysis)
- Severe hematologic disorders
- HIV/AIDS
- Chronic lung disorders
- Chronic and disabling mental health conditions
- Neurologic disorders
- Stroke
If you don't qualify to join this plan, be sure to compare Medicare Advantage plans available in Maricopa County, AZ. A second option is to keep your original Medicare benefits and add a Arizona Medigap plan and a stand-alone Arizona Medicare Part D plan.
Before Joining Bright Advantage Harmony Choice Plan, Consider These Questions:
- If dual-eligibleDual-eligible beneficiaries are those who receive both Medicare and Medicaid benefits. It includes beneficiaries enrolled in Medicare Part A and/or Part B while receiving full Medicaid and/or financial assistance through a Medicare Savings Program...., does the plan coordinate my Medicare and MedicaidMedicaid is a public health insurance program that provides health care coverage to low-income families and individuals in the United States. 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-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... 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 formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan's formulary are generally not covered.?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
How Much Does Bright Advantage Harmony Choice Plan Cost?
The premium on this plan is $40.00 per month. That includes your prescription drugs, as well. Plus, you must continue to pay 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.... Copayments and/or coinsurances also apply with most healthcare services, except preventive care mandated by CMS.
Although the health plan itself does not have a deductible, the prescription drug plan does. It's $480.00 per year. That means you pay 100% of your prescription costs until you've spent $480.00, then the plan will begin paying it's share.
Medicare 5-Star Ratings
In this section we show you the quality rating for this Bright HealthCare plan. Each year CMS rates health plans (Part C) in five broad categories and drug plans (Part D) in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this health plan.
Bright Advantage Harmony Choice Plan 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:
| Tier | Preferred | Standard |
|---|---|---|
| 1 (Preferred Generic) | N/A | $0 copay |
| 2 (Generic) | N/A | 25% |
| 3 (Preferred Brand) | N/A | 25% |
| 4 (Non-Preferred Drug) | N/A | 25% |
| 5 (Specialty Tier) | N/A | 25% |
| 6 (Select Care Drugs) | N/A | $0 copay |
Contact Bright HealthCare
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 AdvantageMedicare 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). program on www.medicare.gov. To learn more about this plan, visit the Bright HealthCare Medicare website.
Plan Availability
Bright Advantage Harmony Choice Plan is available to beneficiaries living in Phoenix, New River, Chandler Heights, Queen Creek, Tortilla Flat, Mesa, Chandler, Gilbert, Higley, Scottsdale, Paradise Valley, Rio Verde, Fort Mcdowell, Fountain Hills, Tempe, Glendale, Luke Air Force Base, Aguila, Arlington, Avondale, Buckeye, Cave Creek, Cashion, El Mirage, Gila Bend, Goodyear, Laveen, Litchfield Park, Morristown, Palo Verde, Peoria, Sun City, Tolleson, Tonopah, Waddell, Wickenburg, Wittmann, Youngtown, Surprise, Sun City West, Carefree, and all other areas of Maricopa County, Arizona; Medicare plans are the same throughout the County.
Citations & References
- https://www.medicare.gov/find-a-plan
- https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/special-needs-plans-snp
- https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/I-SNPs
- https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/D-SNPs
- https://www.cms.gov/Medicare/Health-Plans/SpecialNeedsPlans/C-SNPs
- https://www.shiptacenter.org/
The Medicare Special Needs Plan (SNP) data in this directory originates from CMS Landscape Source Files, is maintained by David Bynon and was last updated on .