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MD Care Benefit Plans
| Part B Premium Credit |
$0 |
$15 Part B credit |
| PCP/Specialist |
$0 / $0 |
$0 / $0 |
| Chiropractic |
$0 |
$0 |
| Podiatry |
$0 |
$0 |
| Generic/Mail Order |
$0 / $0 |
no |
| Preferred Brand/Mail Order |
$15 / $30 |
no |
| Non Preferred Brand/Mail Order |
$50 / $100 |
no |
| Specialty RX |
25% Coinsurance |
no |
| Gap Coverage |
yes |
no |
| Hospital |
$0 |
$0 |
| Inpatient Mental |
$250 deductible
$0 up to 190 days
Max Days 190 Lifetime |
$0 up to 190 days
Max Days 190 Lifetime |
| SNF |
$0 Days 1 - 20
$0 Days 21-100 |
$0 Days 1 - 20
$0 Days 21 - 100 |
| Outpatient Ambulatory Surgical Center |
$0 - $50 |
$0 |
| Ambulance |
$0 - $50 |
$50 |
| ER Co-pay |
$0 - $50 |
$0 |
| World Wide Emergency Coverage |
Yes |
Yes |
| Urgent Care |
$0-$25 |
$0 |
| DME |
0% - 20% Coinsurance |
0% Coinsurance |
| Prosthetics |
0% - 20% Coinsurance |
0% Coinsurance |
| Diagnostic lab |
$0 |
$0 |
| Therapeutic Radiology |
$0 |
$0 |
| Diagnostic X-Rays |
$0 |
$0 |
| Dental Cleaning |
Yes |
Yes |
| Diagnostic Hearing Exam |
Yes |
Yes |
| Eye Glasses |
$0 Up to $200/2 years |
$0 up to $200/year |
| Transportation |
$0 unlimited |
$0 unlimited |
| Respite Care |
52 hours of Respite Care |
52 hours of Respite Care |
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