CareWell Benefits*

  • $0 or up to $42.30 monthly plan premium
  • $0 or $92 or $445 Part D deductible
  • Medicare Prescription Drug Coverage (Part D)— 0 or 25% coinsurance
    • Generic copay: $0 or $1.30 or $4.00
    • All other drugs copay: $0 or $3.70 or $9.20
  • $0 or 20% coinsurance for Primary Care visits in person or telehealth
  • $0 or 20% coinsurance for Specialists visits in person or telehealth
  • $0 Screenings and Immunizations
  • $0 or 20% coinsurance for eye exam
  • $0 Dental Comprehensive Services – $1,350 Maximum Benefit Limit
  • $0 Annual Routine Hearing Exam— Our plan pays up to $1,500 every 3 years for Hearing Aids
  • $0 Telehealth Services
  • $0 or 20% coinsurance podiatry (foot care)
  • $0 FreeStyle and OneTouch diabetic supplies
  • $0 Alternative Therapies-May include Dance Movement Therapy, Music Therapy, Meditation, Chair Yoga or Tai-Chi; 6 sessions per year
  • Nurse Practitioner and Licensed Masters Social Worker to coordinate benefits

For more information about covered services associated and cost-sharing (e.g., co-payments, co-insurance and deductibles) including any conditions and limitations please refer to the  2021 CareWell Summary of Benefits

* Depending on your Medicaid eligibility, you may pay a lower cost share amount.
This plan uses a formulary. Limitations may apply.