AgeWell New York Advantage Plus Benefits*

• $0 monthly plan premium
• $0 Part D yearly deductible
• Medicare Prescription Drug Coverage (Part D)
  Generic copay: $0 or $1.30 or $3.70
  All other drugs copay: $0 or $4.00 or $9.20
• $0 copay Primary Care visits in-person visit or telehealth services
• $0 copay Specialist visits (no referrals) in-person visit or telehealth services
• $0 copay Screenings & Immunizations
• $100 per month/$1,200 every year Over-the-Counter Card (OTC)
• $0 Annual Eye Exam-Eyeglasses every two years
• $0 for Annual hearing exam-  $1,500 every two years for hearing aids 
• $0 Dental Preventive & Comprehensive Services
• $0 copay Diabetic Supplies
• $0 Emergency Care/Urgent Care Services

The above describes benefits that you are entitled to based on your Medicare & full Medicaid eligibility.  Please Refer to the AgeWell New York Advantage Plus (HMO D-SNP) Member materials for additional information in regards to benefits available under the Medicaid Advantage Plus Plan.

2021 MAP Summary of Benefitsopens PDF file

*Must maintain eligibility requirements for $0 cost share

This plan uses a formulary. Limitations may apply.