0 2020 Friday Health Plans Silver SV Plan (Cost) H0657-005 By Friday Health Plans of Colorado.
2020 Friday Health Plans Silver SV Plan (Cost) H0657-005 By Friday Health Plans of Colorado.

2020 Medicare Advantage Plan Services for
Friday Health Plans Silver SV Plan (Cost)


Friday Health Plans Silver SV Plan (Cost) H0657-005 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Friday Health Plans of Colorado available to residents in Colorado. This plan does not provide additional Medicare prescription drug (Part-D) coverage. The Friday Health Plans Silver SV Plan (Cost) has a monthly premium of $45.00 and has an in-network Maximum Out-of-Pocket limit of $6,700 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $6,700 out of pocket. This can be a extremely nice safety net.

Friday Health Plans Silver SV Plan (Cost) is a Cost * plan. A Cost plan is operated by a Health Maintenance Organization (HMO) in accordance with a cost reimbursement contract. A Medicare Cost Plan is a type of HMO. These plans may work in much the same way, and have some of the same rules, as Medicare Advantage Plans. You may use the cost plans network of providers or receive their health care services through Original Medicare. With a Cost Plan, if you go to a non-network provider, the services are covered under Original Medicare. You would pay the Medicare Part A and Part B coinsurance and deductibles.

Friday Health Plans of Colorado works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Friday Health Plans Silver SV Plan (Cost) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Friday Health Plans of Colorado and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Friday Health Plans of Colorado except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.





2020 Friday Health Plans of Colorado Medicare Advantage Plan Details

Name:
Friday Health Plans Silver SV Plan (Cost)
ID:
H0657-005
Provider:Friday Health Plans of Colorado
Year:2020
Type: Cost *
Monthly Premium C+D: $45.00
Part C Premium:
MOOP: $6,700






2019 Plan Services

(*2020 Plan services will be added when available)




Health plan deductible


$0



Emergency care/Urgent care


Emergency $75 per visit (always covered)
Urgent care $40 per visit (always covered)



Diagnostic procedures/lab services/imaging


Diagnostic tests and procedures $0 copay
Lab services $0 copay
Diagnostic radiology services (e.g., MRI) 20%
Outpatient x-rays $0 copay



Hearing


Hearing exam $35
Fitting/evaluation Not covered
Hearing aids - inner ear Not covered
Hearing aids - outer ear Not covered
Hearing aids - over the ear Not covered



Preventive dental


Office visit 50%
Oral exam Covered under office visit
Cleaning Covered under office visit
Fluoride treatment Not covered
Dental x-ray(s) Covered under office visit



Comprehensive dental


Non-routine services Not covered
Diagnostic services Not covered
Restorative services Not covered
Endodontics Not covered
Periodontics Not covered
Extractions Not covered
Prosthodontics, other oral/maxillofacial surgery, other services Not covered



Vision


Routine eye exam $35
Other Not covered
Contact lenses Not covered
Eyeglasses (frames and lenses) $0 copay
Eyeglass frames Not covered
Eyeglass lenses Not covered
Upgrades Not covered



Mental health services


Inpatient hospital - psychiatric $1,175 per stay
Outpatient group therapy visit with a psychiatrist $40
Outpatient individual therapy visit with a psychiatrist $40
Outpatient group therapy visit $40
Outpatient individual therapy visit $40



Skilled Nursing Facility


$0 per day for days 1 through 20
$164.50 per day for days 21 through 100



Rehabilitation services


Occupational therapy visit $35
Physical therapy and speech and language therapy visit $35



Ground ambulance


$150



Other health plan deductibles?


In-Network No



Transportation


Not covered



Foot care (podiatry services)


Foot exams and treatment $40
Routine foot care Not covered



Medical equipment/supplies


Durable medical equipment (e.g., wheelchairs, oxygen) 20% per item
Prosthetics (e.g., braces, artificial limbs) 20% per item
Diabetes supplies 20% per item



Wellness programs (e.g., fitness, nursing hotline)


Covered



Medicare Part B drugs


Chemotherapy Not Applicable
Other Part B drugs Not Applicable



Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)


$6,700 In-network



Optional supplemental benefits


No



Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?


In-Network No



Inpatient hospital coverage


$1,175 per stay



Outpatient hospital coverage


$300 per visit



Doctor visits


Primary $35 per visit
Specialist $50 per visit



Preventive care


$0 copay




Coverage Area for Friday Health Plans Silver SV Plan (Cost)

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Source: CMS.
Data as of September 4, 2019.
Star Rating as of October 10, 2019.
Plan Services are 2019 information as reference. 2020 information will be added when released.
Notes: Data are subject to change as contracts are finalized. For 2020, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit. Includes 2020 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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