2021 Longevity Health Plan (PPO I-SNP) DS-H9942

Longevity Health Plan (PPO I-SNP) By Longevity Health Plan



Longevity Health Plan (PPO I-SNP) is a 2021 Medicare Advantage Special Needs Plan plan by Longevity Health Plan. This plan from Longevity Health Plan works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Longevity Health Plan and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. Longevity Health Plan (PPO I-SNP) DS-H9942 is an Institutional SNP (I-SNP). An Institutional SNP is for beneficiaries who live in an institution such as a nursing home or require nursing care at home. If you live in an institution like a nursing home or hospital you can join any Medicare SNP you qualify for or switch plans at any time.



2021 Medicare Special Needs Plan Details

Plan Name:
Longevity Health Plan (PPO I-SNP)
Plan ID:
DS-H9942
Special Needs Type: Institutional
Provider: Longevity Health Plan
Plan Year:2021
Plan Type: Local PPO
Monthly Premium C+D: $37.30


The Longevity Health Plan (PPO I-SNP) DS-H9942 is available to residents in New Jersey, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. Longevity Health Plan (PPO I-SNP) is a Local PPO. A preferred provider organization (PPO) is a medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.



Part-C Premium

Longevity Health Plan plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.



Part-D Deductible and Premium

The Longevity Health Plan (PPO I-SNP) plan has a monthly drug premium of $37.30 and a $445.0 drug deductible. This Longevity Health Plan plan offers a $37.30 Part D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Longevity Health Plan above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $37.30. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.



Premium Assistance

Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Longevity Health Plan (PPO I-SNP) medicare insurance plan offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $9.30 for 75% low income subsidy $18.60 for 50% and $28.00 for 25%.



Part C Premium: $0
Part D (Drug) Premium: $37.30
Part D Supplemental Premium $0
Total Part D Premium: $37.30
Drug Deductible: $445.0
Tiers with No Deductible: 0
Benchmark: below the regional benchmark
Type of Medicare Health Plan: Defined Standard Benefit
Drug Benefit Type: Basic
Full LIS Premium: $0
75% LIS Premium: $9.30
50% LIS Premium: $18.60
25% LIS Premium: $28.00
Gap Coverage: No


Gap Coverage

In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. This Longevity Health Plan plan does not offer additional coverage through the gap.




Longevity Health Plan (PPO I-SNP) Part-C Premium

Longevity Health Plan plan charges a $0 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.



DS-H9942 Part-D Deductible and Premium

Longevity Health Plan (PPO I-SNP) has a monthly drug premium of $37.30 and a $445.0 drug deductible. This Longevity Health Plan plan offers a $37.30 Part D Basic Premium that is below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0 this Premium covers any enhanced plan benefits offered by Longevity Health Plan above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $37.30. The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.



Longevity Health Plan Gap Coverage

In 2021 once you and your plan provider have spent $4130 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Longevity Health Plan plan does not offer additional coverage through the gap.



DS-H9942 Formulary or Drug Coverage

Longevity Health Plan (PPO I-SNP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.

Drug Tier Copay
Preferred
Pharmacy
Copay
Nonpreferred
Pharmacy
Tier 1 NA 25%
*Initial Coverage Phase and 30 day supply








Coverage Area for Longevity Health Plan (PPO I-SNP)



Source: CMS.

Plans as of September 9, 2020.

Notes: Data are subject to change. All contracts for 2020 have not been finalized. For 2020, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.

Includes 2020 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

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