Any doctor. Any time. Anywhere…
Preferred Care GoldAnywhere
Overview/Plan Highlights
With improved Medicare Part D prescription drug
coverage…plus NEW dental coverage!
Preferred Care GoldAnywhere offers you flexibility and choice! You may choose Preferred Care GoldAnywhere:
- With prescription drug coverage for $87.60 a month, or
- Without prescription drug coverage
for $44.60 a month.
Features to help keep you healthy and independent
With Preferred Care GoldAnywhere, you can see any doctor or specialist at any time
with no referrals**.
And when you see a doctor in our network of more than 4,500 doctors and hospitals, you lower your out-of-pocket costs! GoldAnywhere now has improved Medicare Part D prescription drug coverage and comprehensive benefits including:
- No deductible.
- Copays of $5 / $45 / 25% (depending on drug tier) for the first $2,510 in total drug costs. When your annual out-of-pocket drug costs equal $4,050, you pay $2.25 generic / $5.60 brand name or 5%, whichever is greater.
- More coverage for Tier 1 (generic) drugs in the Part D coverage gap—you pay only $5 for Tier 1 (generic) drugs!
- Coverage for all medically necessary Medicare Part D-approved drugs..
| Plan Highlights |
In-Network |
Out-of-Network |
Monthly premium with prescription drug (Part D)
(you must continue to pay Medicare Part B premium) |
$87.60 |
$87.60 |
Monthly premium without prescription drug (Part D)
(you must continue to pay Medicare Part B premium)
|
$44.60 |
$44.60 |
Annual deductible
(must be met before out-of-network benefits pay) |
None |
$500* |
Annual out-of-pocket maximum
(once met, plan pays 100%) |
None |
$2,500 |
| Doctor visit copay |
$10 |
$25 |
| Specialist copay |
$15 |
$25 |
| Inpatient hospital copay |
|
20% |
| Free Preferred Care wellness classes and programs |
Yes |
Yes |
| The SilverSneakers® Fitness Program - free fitness center membership benefits! |
Yes |
Yes |
| Outpatient surgery copay, e.g. cataracts |
|
20% |
| Choice of hospitals |
Yes |
Yes |
More than 5,000 local health care providers to
choose from |
Yes |
Yes |
| Worldwide coverage for emergency and urgent care, and renal dialysis (no deductible or out-of-pocket maximum) |
Yes |
Yes |
| Coverage for routine care while you travel |
Yes-subject
to in-or out-of-
network* |
Yes-subject
to in-or out-of-
network* |
Help with the cost of hearing aids
($600 allowanceevery 3 years) |
Yes |
Yes |
| New! Help with routine dental care — annual $300 allowance
(any unused portion cannot carry over to the next calendar year) |
Yes |
Yes |
Help with the cost eyewear—annual $100 allowance
(any unused portion of this benefit cannot be carried
over from one calendar year to the next) |
Yes |
Yes |
$50 free HealthDollarssm to use toward health programs (any unused portion cannot carry over to the next calendar year) |
Yes |
Yes |
If your coverage is through your former employer, some benefits may not apply. |
To enroll, call one of our Preferred Care Gold Advisors:
You can also a sk questions, reserve a seat at a neighborhood information meeting, or schedule an in-home visit:
Monday – Friday, 8:00 a.m. to 5:00 p.m. Eastern Time
(585) 327-5760 or (888) 280-6205
TTY users may call (585) 325-2629 or (800) 252-2452
Already a GoldAnywhere member?
Call Preferred Care Member Services.
Representatives are available to serve you Monday - Friday from 7:00 a.m. to
8:00 p.m. Eastern Time at
(585) 327-2480 or (800) 665-7924.
TTY users may call (585) 325-2629 or (800) 252-2452.
From November 15 -
March 1, phone representatives also are available weekends from 8:00 a.m. to 8:00 p.m.
*Out-of-network benefits (except for emergency or urgent care, or renal dialysis) are subject to a $500 annual deductible (must be met before out-of-network benefits pay) and a $2,500 annual out-of-pocket maximum (once met, plan pays 100%).
**Some services require “prior authorization.” If your coverage is through your former employer, some benefits may not apply.
Preferred Care is an HMO/PPO with a Medicare Advantage contract serving Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Steuben, Wayne, Wyoming, and Yates counties.
H3346 PPO 459 (10/07)
Last updated: June 2008
|
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