LiveWell Benefits
- $42.30 monthly plan premium
- $350 Part D deductible (Drugs in Tier 1 and Tier 2 are excluded from the deductible)
- Medicare Prescription Drug Coverage (Part D) Copays: Tier 1–$3, Tier 2–$15, Tier 3–$47, Tier 4–$100, Tier 5–26% coinsurance
- $15 copay Primary Care visits in person or telehealth ($0 annual routine physical exam)
- $40 copay Specialist visits in person or telehealth
- $20 copay Physical Therapy
- $0 annual routine eye exam.
Optional $9 Vision monthly premium – covers up to $275 every year for eyeglasses
- $0 for Annual Routine hearing exam- Our plan pays up to $1,000 every 2 years for Hearing Aids
- Optional $16 Dental monthly premium—Preventive & Comprehensive Services
- $10 copay Acupuncture – 10 treatments per year
- $20 copay Chiropractor
- $0 Screenings & Immunizations
- $0 Telehealth Services
- Wellness Coach to help you access all your health 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 LiveWell Summary of Benefitsopens PDF file