2023 Neighborhood INTEGRITY (Medicare-Medicaid Plan)

Neighborhood INTEGRITY (Medicare-Medicaid Plan) H9576-001 is a 2023 Medicare Advantage Plan or Part-C by NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND available to residents in Rhode Island. This plan includes additional prescription drug (Part-D) coverage. NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND Neighborhood INTEGRITY (Medicare-Medicaid Plan) has a monthly premium of $0 and has an in-network maximum out-of-pocket limit of $- (MOOP). This means that if you get sick or need a high-cost procedure the co-pays are capped once you pay $- out-of-pocket. This can be an extremely nice safety net.

NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Neighborhood INTEGRITY (Medicare-Medicaid Plan) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND and not Original Medicare. With 2023 Medicare Advantage Plan you are always covered for urgently needed and emergency care. Plus, you receive all the benefits of Original Medicare from NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND except hospice care. Original Medicare still provides you with hospice care if you sign up for Medicare Advantage in Rhode Island.




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2023 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND Medicare Advantage Plan Overview

Name:Neighborhood INTEGRITY (Medicare-Medicaid Plan)
Plan ID:H9576 001 0
Provider:NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND
Year:2023
Type:MMP
Combined Premium (C+D):$0/mo
Part C Premium:/mo
MOOP:$-/yr
Part D (Drug) Premium:$0/mo
Part D Supplemental Premium$0/mo
Total Part D Premium:$0/mo
Drug Deductible:$0/yr
Tiers with No Deductible:0
Gap Coverage:Yes
Benchmark:Not below the regional benchmark
Type of Medicare Health:Enhanced Alternative
Drug Benefit Type:Enhanced
Similar Plan: H9576-001




What type of plan is Neighborhood INTEGRITY (Medicare-Medicaid Plan)



How much does Neighborhood INTEGRITY (Medicare-Medicaid Plan) cost?


Monthly Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND charges a $0 consolidated premium. The Part C premium is this charge 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

An annual deductible is the amount you pay out-of-pocket for your prescription drugs before your plan begins to pay. Neighborhood INTEGRITY (Medicare-Medicaid Plan) has a monthly drug premium of $0 and a $0 drug deductible. This NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND plan offers a $0 Part-D Basic Premium that is Not 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 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND 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 $0. The Part D Total Premium is the addition of supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.


NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND Gap Coverage

In 2023 once you and your plan provider have spent $4660 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 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND plan does offer additional coverage through the gap.


Formulary and Drug Coverage

Neighborhood INTEGRITY (Medicare-Medicaid Plan) 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 $0
Tier 2 NA $0
Tier 3 NA $0

The complete Neighborhood INTEGRITY (Medicare-Medicaid Plan) Formulary.
*Initial Coverage Phase and 30 day supply





2023 Summary of Benefits


The benefit information provided is a summary of what Neighborhood INTEGRITY (Medicare-Medicaid Plan) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

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



Contact lenses


Vision$0 copay



Eyeglass frames


Vision$0 copay



Eyeglass lenses


Vision$0 copay



Eyeglasses (frames and lenses)


Vision$0 copay



Other


Vision$0 copay



Routine eye exam


Vision$0 copay



Upgrades


VisionNot covered




TransportationNot covered
Skilled Nursing Facility$0 copay



Occupational therapy visit


Rehabilitation services$0 copay



Physical therapy and speech and language therapy visit


Rehabilitation services$0 copay



Cleaning


Preventive dentalNot covered



Dental x-ray(s)


Preventive dentalNot covered



Fluoride treatment


Preventive dentalNot covered



Oral exam


Preventive dentalNot covered




Preventive care$0 copay
Outpatient hospital coverage$0 copay
In-Network Other health plan deductibles?No
Optional supplemental benefitsNo



Inpatient hospital - psychiatric


Mental health services$0 copay



Outpatient group therapy visit


Mental health services$0 copay



Outpatient group therapy visit with a psychiatrist


Mental health services$0 copay



Outpatient individual therapy visit


Mental health services$0 copay



Outpatient individual therapy visit with a psychiatrist


Mental health services$0 copay



Chemotherapy


Medicare Part B drugs$0 copay



Other Part B drugs


Medicare Part B drugs$0 copay



Diabetes supplies


Medical equipment/supplies$0 copay



Durable medical equipment (e.g., wheelchairs, oxygen)


Medical equipment/supplies$0 copay



Prosthetics (e.g., braces, artificial limbs)


Medical equipment/supplies$0 copay




Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)Not Applicable
Inpatient hospital coverage$0 copay



Fitting/evaluation


Hearing$0 copay



Hearing aids


Hearing$0 copay



Hearing exam


Hearing$0 copay




Health plan deductible$0
Ground ambulance$0 copay



Foot exams and treatment


Foot care (podiatry services)$0 copay



Routine foot care


Foot care (podiatry services)$0 copay



Emergency


Emergency care/Urgent care$0 copay



Urgent care


Emergency care/Urgent care$0 copay



Primary


Doctor visits$0 copay



Specialist


Doctor visits$0 copay



Diagnostic radiology services (e.g., MRI)


Diagnostic procedures/lab services/imaging$0 copay



Diagnostic tests and procedures


Diagnostic procedures/lab services/imaging$0 copay



Lab services


Diagnostic procedures/lab services/imaging$0 copay



Outpatient x-rays


Diagnostic procedures/lab services/imaging$0 copay



Diagnostic services


Comprehensive dentalNot covered



Endodontics


Comprehensive dentalNot covered



Extractions


Comprehensive dentalNot covered



Non-routine services


Comprehensive dentalNot covered



Periodontics


Comprehensive dentalNot covered



Prosthodontics, other oral/maxillofacial surgery, other services


Comprehensive dental$0 copay



Restorative services


Comprehensive dentalNot covered




In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?No





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Coverage Area

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The availability of Medicare Advantage Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Neighborhood INTEGRITY (Medicare-Medicaid Plan) requires you to live in that plan’s service area. The service area is listed below:



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How much does Neighborhood INTEGRITY (Medicare-Medicaid Plan) cost?

NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND charges a $0 consolidated monthly premium. A monthly premium is the fee you pay to the plan in exchange for coverage of Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

How much is Neighborhood INTEGRITY (Medicare-Medicaid Plan) MOOP?

The maximum out-of-pocket (MOOP) is a yearly limit on your out-of-pocket costs. Neighborhood INTEGRITY (Medicare-Medicaid Plan) by NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND MOOP is $-. Once you spend $- you will pay nothing for Part A or Part B covered services.

What type of plan is Neighborhood INTEGRITY (Medicare-Medicaid Plan)?



Source:CMS. Data as of Oct 1, 2022.

Last updated on

Notes: Data are subject to change as contracts are finalized. For 2023, 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 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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