HMSA可以帮助你过上最好的生活.
HMSA is here with you.
| wcagcolheader | Akamai Advantage Complete (PPO) | Akamai Advantage Complete Plus (PPO) | |
|---|---|---|---|
|
Monthly premium 低收入补贴可以帮助支付处方药和每月保费. Find out more. |
$0 | $104 | |
|
网络内自付最大值 (这是你每年为医疗保险服务支付的最高费用.) |
$6,700 | $3,450 | |
| 2023 Star Rating |
3.5 out of 5 Star Rating (H3832). |
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| Provider directory | |||
| Medical Benefits* | |||
| You Pay | You Pay | ||
| Annual deductible | 一些网内和网外服务每年120美元 | $0 | |
| Inpatient hospital care* |
Days 1 to 6:
Days 7 to 60:
Days 61 to 90: |
Days 1 to 6:
Days 7 to 90:
Additional Days: |
|
| Skilled nursing facility* |
Days 1 to 20:
Days 21 to 60:
Days 61 to 100: |
Days 1 to 20:
Days 21 to 40:
Days 41 to 100: |
|
| 医院门诊设施和流动手术中心服务* | $120 deductible, then 20% | 20% | |
| 初级保健提供者办公室访问 | $0 | $0 | |
| 专业护理提供者办公室访问 | $50 | $30 | |
| Annual wellness visit | $0 | $0 | |
|
Ambulance service Includes ground and air. |
$250 | $225 | |
| Emergency care | $90 | $90 | |
| Urgent care | $50 | $30 | |
| 全球覆盖的紧急和紧急护理服务 | 10% | 10% | |
| 诊断测试和程序、实验室服务和门诊x光* | 20% | 20% | |
| 化疗和其他B部分药物* | 20% | 20% | |
| 医疗设备和用品* | 20% | 20% | |
| Dental Benefits | |||
| Preventive dental services, 包括每年两次口语考试, two cleanings every year, one set of X-rays every year, 还有每年两次氟化物处理 | $0 | $0 | |
| 全面的牙科服务，包括每年四次拔牙及两次补牙 | $0 | $0 | |
| Comprehensive dental services, 包括每年一次根管治疗和每年一次根管治疗后的牙冠 | Not covered | $0 | |
| Dental Provider Directory | Download | ||
| Vision Benefits | |||
| You Pay | You Pay | ||
| Routine eye exam | $10/1 exam per calendar year | $0/1 exam per calendar year | |
| Eyewear (supplemental) |
镜框、镜片或隐形眼镜0美元 计划每年支付高达200美元 |
镜框、镜片或隐形眼镜0美元 计划每年支付高达200美元 |
|
| Wellness Benefits | |||
|
Silver&Fit Healthy Aging & Exercise Program
参加健身中心的会员, one home fitness kit per year, 健康老龄化辅导课程等等. |
Fitness Membership:
Home Fitness Kit
Healthy Aging Coaching
Digital Workout Videos |
Fitness Membership:
Home Fitness Kit
Healthy Aging Coaching
Digital Workout Videos |
|
| Telehealth Includes HMSA’s Online Care. |
$0 | $0 | |
| Health Education | Learn more | Learn more | |
| Health Coaching | Learn more | Learn more | |
| Drug Benefits | |||
| You Pay | You Pay | ||
|
Annual deductible 低收入补贴可以帮助支付处方药和每月保费. Find out more. |
$380 (Does not apply to Tier 1) |
$0 |
|
|
Initial coverage stage 直到药品总成本达到4660美元 |
|||
| 零售药店30天供应 | |||
| $4.50 | $4 | ||
| $12 | $11 | ||
| $47 | $45 | ||
| $100 | $95 | ||
| 25% | 33% | ||
| 来自邮购药店的90天供应 | |||
| $4.50 | $4 | ||
| $12 | $11 | ||
| $94 | $90 | ||
| $200 | $190 | ||
| 25% | 33% | ||
|
Coverage gap 直到你每年的自付药费达到7400美元 |
品牌药或仿制药成本的25% | ||
| 一级药物的额外缺口覆盖 | |||
| 零售药店30天供应 | Not covered | $4 | |
| 来自邮购药店的90天供应 | Not covered | $4 | |
|
Catastrophic coverage 扣除你每年的自付药费 reach $7,400 |
The greater of 5% or $4.仿制药(包括被当作仿制药对待的品牌药)15美元，10美元.35 for all other drugs. | ||
| Pharmacy | Find a pharmacy | ||
|
处方药清单(处方) 看看你的处方药是否在医保范围内，然后寻找价格更低的替代品. Drug Search Tool. |
Download
Request hard copy |
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| Resources and Plan Materials | |||
| Summary of Benefits | Download | Download | |
| Evidence of Coverage |
Download Request hard copy |
Download Request hard copy |
|
| Member Resources | Learn more | Learn more | |
*对于某些服务，您的医生或其他网络提供商可能会要求事先授权. 请澳门特区赌场开户了解更多信息.
