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 Benefits