2024 Independent Health's Medicare Family Choice I-SNP: H3362-020-0 by Independent Health
What is Plan H3362-020-0 by Independent Health?
Independent Health's Medicare Family Choice is a I-SNP Medicare Advantage plan, by Independent Health, for 2024. It has a HMO provider network. This Independent Health HMO plan is required to provide all of the same benefits as Original Medicare, and includes some additional benefits, but out-of-pocket costs with this private health insurance option may be different.
Medicare beneficiaries must meet all qualification requirements for eligibility to join this HMO I-SNP plan.
CMS rated this plan 5.0 (Excellent) stars, making it a top-rated plan from this insurance company.
Plan Basics | |
---|---|
Plan ID: | H3362-020-0 |
Plan Type: | HMO |
Plan Year: | 2024 |
Premium: | $48.70/mo Plus your Part B premium. |
Health Plan Deductible: | $0.00 |
Out-of-Pocket Maximum: | /yr |
Part B Reduction: | $0.00/mo |
Drug Plan Benefit: | Enhanced $0.00 deductible |
Rx Gap Coverage: | {gap} |
Supplemental Benefits: | Vision, Hearing |
Availability: | See List |
Insured By: | Independent Health |
Summary of Benefits |
---|
Health Plan Cost Sharing & Benefits
Independent Health's Medicare Family Choice is a Health Maintenance Organization (HMO) plan. HMO I-SNP plan members usually receive health care services through the plan’s local network of providers. Referrals are almost always required to see a specialist and other providers. However, Independent Health's Medicare Family Choice does allow out-of-network care for emergencies and out-of-area dialysis.
The following table is a summary of the most common out-of-pocket costs you will incur if you join this Independent Health plan:
Healthcare Service | Member Cost |
---|---|
Doctor Visits (In-Network) | |
Primary: | $0 |
Specialist: | $0 |
Wellness programs (e.g., fitness, nursing hotline): | |
Preventive care: | $0 |
Foot Care (In-Network) | |
Foot exams and treatment (Medicare-covered): | $0 |
Routine foot care: | $0 |
Chiropractic Care (In-Network) | |
Medicare-covered chiropractic care: | $0 |
Routine chiropractic care: | $0 |
Emergency Care / Urgent Care | |
Emergency room care: | $100 Copay |
Urgent care: | $0 |
Ground ambulance: | $80 Copay |
Inpatient hospital coverage: | $250.00 per stay |
Outpatient hospital coverage: | $0 |
Skilled Nursing Facility: | Unknown |
Optional supplemental benefits: | Not Covered |
Mental Health Services (In-Network) | |
Outpatient individual therapy visit with a psychiatrist: | $0 |
Outpatient group therapy visit with a psychiatrist: | $0 |
Inpatient hospital - psychiatric: | $250.00 per day for days 1 through 5 $0.00 per day for days 6 and beyond |
Outpatient group therapy visit: | $0 |
Outpatient individual therapy visit: | $0 |
Rehabilitation Services (In-Network) | |
Physical therapy and speech and language therapy visit: | $0 |
Occupational therapy visit: | $0 |
Medical Equipment / Supplies (In-Network) | |
Diabetes supplies: | $0 |
Durable medical equipment (e.g., wheelchairs, oxygen): | 10% Coinsurance Prior Authorization Required |
Prosthetics (e.g., braces, artificial limbs): | 10% Coinsurance |
Diagnostic Procedures / Lab Services / Imaging (In-Network) | |
Diagnostic radiology services (e.g., MRI): | 10% Coinsurance Prior Authorization Required |
Lab services: | 20% Coinsurance Prior Authorization Required |
Outpatient x-rays: | 10% Coinsurance Prior Authorization Required |
Diagnostic tests and procedures: | $0 |
Medicare Part B Drugs (In-Network) | |
Chemotherapy: | $0 |
Other Part B drugs (Medicare-covered) | $0 |
Feel free to download our Independent Health's Medicare Family Choice Summary of Benefits information.
Supplemental Health Plan Benefits (H3362-020-0)
The following is a summary of the supplemental benefits Independent Health includes with this plan:
Supplemental Healthcare Service | Member Cost |
---|---|
Preventive Dental | |
Oral exam (In-Network) | Not Covered |
Fluoride treatment (In-Network) | Not Covered |
Dental x-ray(s) (In-Network) | Not Covered |
Cleaning (In-Network) | Not Covered |
Comprehensive Dental | |
Periodontics (In-Network) | Not Covered |
Non-routine services (In-Network) | Not Covered |
Diagnostic services (In-Network) | Not Covered |
Extractions (In-Network) | Not Covered |
Endodontics (In-Network) | Not Covered |
Restorative services (In-Network) | Not Covered |
Prosthodontics, other oral/maxillofacial surgery, other services (In-Network) | Not Covered |
Hearing | |
Fitting/evaluation (In-Network) | $45 Copay Limitations Apply |
Hearing aids (In-Network) | Covered Limits may apply |
Hearing exam (In-Network) | Covered Limits may apply |
Vision | Maximum vision benefit: | $150.00 Every year |
Eyeglasses (frames and lenses) (In-Network) | Covered Limits may apply |
Routine eye exam (In-Network) | Covered Limits may apply |
Contact lenses (In-Network) | Covered Limits may apply |
Additional Supplemental Benefits
None specified.
Prescription Drug Plan Costs & Benefits
Independent Health's Medicare Family Choice includes an enhanced benefit Medicare Part D plan (PDP). Enhanced plans have a higher actuarial value than basic plans. Actuarial value simply refers to the percentage of cost that's covered by the plan.
Prescription Drug Plan Premium
Although the prescription drug plan (Part D) premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidy (LIS) assistance. The following table outlines the prescription drug plan premium details of this plan.
Basic Part D Premium: | $48.70 |
Supplemental Part D Premium: | $0.00 |
Total Part D Premium: | $48.70 |
Part D Premium with Full LIS Assistance: | $0.00 |
For more information about the Low-Income Subsidy (aka, "Extra Help") program, refer to the Social Security Extra Help page.
Prescription Drug Plan Deductible
The Medicare Part D annual deductible with this plan is $0.00. This is the amount you must pay at the pharmacy before Independent Health begins paying its share.
Prescription Drug Plan Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, Independent Health's Medicare Family Choice has out-of-pocket costs that you must pay when you pick up your prescriptions. The following table shows you those costs.
Drug Tier | Preferred | Standard |
---|---|---|
1 (Preferred Generic) | N/A | $4.00 copay |
2 (Generic) | N/A | $15.00 copay |
3 (Preferred Brand) | N/A | 25% |
4 (Non-Preferred Drug) | N/A | 25% |
5 (Specialty Tier) | N/A | 33% |
5-Star Rating Marks
Each year the Centers for Medicare & Medicaid Services (CMS) rates Medicare Advantage I-SNP's in nine broad categories using a 5-star rating system. Medicare's star ratings will help you understand the quality of care and service you can expect if you join this Independent Health 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 |
How to Qualify to Enroll in
Independent Health's Medicare Family Choice
To be eligible to enroll in Independent Health's Medicare Family Choice, you must meet three requirements:
- You are eligible for Medicare;
- You live in County (the plan’s service area); and
- You require the level of care provided in an institutionalized setting, such as a long-term care nursing facility, for 90 days or more.
If you live at home and require an equivalent level of skilled care, you may be eligible for an Institutional Equivalent Special Needs Plan (IE-SNP).
Before joining Independent Health's Medicare Family Choice, consider these questions:
- Does the plan's provider network include my nursing home or home care provider?
- What costs should I expect with my coverage (premiums, deductibles, copayments)?
- Is there an annual limit on my out-of-pocket costs?
- 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 Part D plan's formulary?
- What special accommodations does the plan make for persons with disabilities?
- What special language and cultural accommodations does the plan make?
Plan Availability
Independent Health's Medicare Family Choice (H3362-020-0) is available in the following locations (click to open):
Additional I-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
- H3362-020-0: Independent Health's Medicare Family Choice (I-SNP)
- H3362-040-0: Independent Health's Assure Advantage (C-SNP)
Contact Independent Health
Plan Website: | http://www.independenthealth.com/medicare |
---|---|
Formulay Information: | http://www.independenthealth.com |
Pharmacy Information: | Independent Health Pharmacy Page |
Prospective Members: | (800)958-4405 |
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.
Health Plan Compatibility
Medicare Advantage Special Need Plans are not compatible with most other forms of health insurance. If you have Medicare Part A and/or Medicare Part B and join a SNP plan, you will be disenrolled from Original Medicare. You cannot simultaneously enroll in an SNP plan and Medicare Supplement Insurance.
Members of a D-SNP maintain their current Medicaid plan and Medicaid benefits. Veterans with VA Health Benefits might have the option to receive care at a nearby VA hospital.
Plans Offered
Medicare Advantage and Part D plans and benefits offered are 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
- Independent Health, http://www.independenthealth.com/medicare, Last Accessed October 13, 2023
- Medicaid.gov, "Medicaid & CHIP in ", Last Accessed January 4, 2024
- CMS.gov, "Institutional Special Needs Plans (I-SNPs)", Last Accessed January 20, 2023
- CMS.gov, Landscape Source Files, Last Accessed January 2, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed January 2, 2024
- CMS.gov, Plan Benefits Package, Last Accessed January 3, 2024