FeelWell (HMO D-SNP) 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 for Primary Care Provider (PCP) visits – in person or via telehealth
  • $0 copay for Specialist visits – in person or via telehealth
  • $0 copay for screenings and immunizations (vaccines)
  • $0 copay for annual routine eye exam (up to $150 every year for eyeglasses)
  • $0 copay for dental comprehensive services (up to $1,500 maximum benefit limit)
  • $0 copay for annual routine hearing exam (up to $1,000 every 2 years for hearing aids)
  • $0 copay for acupuncture (6 treatments per year)
  • $0 copay for chiropractor services
  • $0 copay for transportation (8 one-way trips)
  • $0 telehealth services
  • Care Manager 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 FeelWell Summary of Benefitsopens PDF file

 

* Depending on your Medicaid eligibility.
This plan uses a formulary. Limitations may apply.