AgeWell New York Advantage Plus Benefits*


A Medicaid Advantage Plus (MAP) Plan
Monthly Plan Premium $0* copay
Part B/C/D Yearly Deductible $0* copay
Maximum out-of-pocket (MOOP) $0 or $3,650*
PCP/Specialist/Telehealth $0* copay
Acupuncture $0 copay per visit, 30 additional visits per year to the Medicare-covered acupuncture
Dental $2,000 per year Comprehensive
Diabetic $0 copay Precision, OneTouch and FreeStyle preferred brands.  (No prior authorization required.) Plus $150 diabetic healthy food card per month.
Emergency Room/ Urgent Care $0* copay
Hearing $1,000 every 2 years for Hearing Aids
Hospital Inpatient/SNF $0* copay
Lab/X-Ray/ Test & Procedures $0* copay
Over-the-Counter (OTC) $225 per month ($2,700 per year)
Outpatient Surgery $0* copay
Physical Therapy $0* copay
Screening & Immunization $0 copay
Telemonitoring Services $0 copay
Transportation Medicaid covered services
Vision One pair of eyeglass frames and lenses
Worldwide Emergency/Urgent Care $50,000 per year

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.

 2023 MAP Summary of Benefitsopens PDF file

* Must maintain eligibility requirements for $0 cost share

This plan uses a formulary. Limitations may apply.