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Shared Health Dual Plus

Plan ID: H3015-1-0

Shared Health Dual Plus (HMO D-SNP)

2024 Shared Health Dual Plus (HMO D-SNP) H30150010 is a Medicare Advantage plan with drug coverage. It has received a 1.5-out-of-5 star rating from CMS for 2024.

Learn more about Shared Health Dual Plus (HMO D-SNP) H3015 - 001 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.

1.5 / 5 stars for 2024

$0.00 /mo

Monthly premium

$0

Health deductible

$545.00

Drug deductible

$0

Out-of-pocket maximum

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1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week!

Overview Icon

Plan Overview

2024 Shared Health Dual Plus (HMO D-SNP) H30150010 is a HMO offered in Mississippi by Shared Health Dual Plus. It has a monthly premium of $25.80.

Important:

2024 Shared Health Dual Plus (HMO D-SNP) H3015001 0 is a Dual-Eligible Special Needs Type plan. You can only enroll in this plan if you meet specific criteria.

Premium Breakdown

Standard Part B Premium

$174.70

Part B premium reduction

- $0

Monthly Plan Premium

$25.80

Total Premium:

$200.50

Note:

The standard Part B premium for 2024 is $174.70. Your Part B premium may differ based on factors including late enrollment, income, and disability status. Higher-income beneficiaries may pay an income-related monthly adjustment amount (IRMAA). The Part B premium is required to be paid by everyone enrolled in Medicare Part B.

Special needs plan type

Yes

Out-of-pocket maximum

$0

Conditions Covered

None

Plan Organization:

Shared Health Dual Plus

Plan Type:

HMO

Location:

Mississippi

Drugs Covered:

Yes

Drug Formulary:

Pharmacies:

Doctor Choice:

Plan Doctors for Most Services

Doctors Link:

Deductibles

The amount you must pay each year before your plan starts to pay for covered services or drugs.

Health deductible

$0

Drug deductible

$545

Note:

This plan does not charge an annual deductible for all drugs. The $545.00 annual deductible only applies to drugs in certain tiers.

Other Plan Notes

  • This plan is a Medicare Special Needs Plan for people with both Medicare and Medicaid. Contact the plan for details.
  • Depending on your level of Extra Help, you may pay less for the drugs than the cost sharing amount listed. Look on the Extra Help letters you get, or contact the plan to find out your exact costs.

Sign up for Shared Health Dual Plus (HMO D-SNP)

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Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 TTY 711. 8am-11pm EST. 7 days a week

Drug Coverage Icon

Drug Coverage

Shared Health Dual Plus (HMO D-SNP) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Benefit Type

Defined Standard Benefit

Prescription drug deductible

$545.00

Increased initial coverage limit

No

Additional gap coverage

No

Part D Premium Reduction

This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.

Part D

LIS 25%

LIS 50%

LIS 75%

LIS Full

$25.80

$25.80

$25.80

$25.80

$25.80

Initial Coverage Phase

After you pay your $545.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $4,660.00. Once you reach that amount, you will enter the next coverage phase.

30 Days
60 Days
90 Days

Tier

Preferred Pharmacy

Standard Pharmacy

Preferred Mail

Standard Mail

1. Preferred Generic

-

25%

-

25%

2. Standard Generic

-

-

-

-

3. Preferred Brand

-

-

-

-

4. Non-Preferred Drug

-

-

-

-

5. Specialty Tier

-

-

-

-

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs.

Generic Drugs

$4.15 copay or 5% (whichever costs more)

Brand-name

$10.35 copay or 5% (whichever costs more)

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Additional Benefits

Shared Health Dual Plus (HMO D-SNP) also provides the following benefits.

Note:

Limits, Authorizations, and Referrals may apply for the benefits below. Contact the plan for details.

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Comprehensive dental

Non-routine services
$0 copay
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Diagnostic services
$0 copay
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Restorative services
$0 copay
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Endodontics
$0 copay
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Periodontics
$0 copay
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Extractions
$0 copay
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Prosthodontics, other oral/maxillofacial surgery, other services
$0 copay
Limit Icon
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Preventive dental

Oral exam
$0 copay
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Cleaning
$0 copay
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Fluoride treatment
Not covered
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Dental x-ray(s)
$0 copay
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Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures
$0 copay
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Lab services
$0 copay
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Diagnostic radiology services (eg, MRI)
$0 copay
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Outpatient x-rays
$0 copay
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Doctor visits

Primary
$0 copay
Specialist
$0 copay
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Emergency care/Urgent care

Emergency
$0 copay
Urgent care
$0 copay
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Foot care (podiatry services)

Foot exams and treatment
$0 copay
Routine foot care
$0 copay
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Ground ambulance

Service
$0 copay
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Hearing

Hearing exam
$0 copay
Fitting/evaluation
$0 copay
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Hearing aids
$0 copay
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Inpatient hospital coverage

Service
$0 copay
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Additional Coverage Icon

Outpatient hospital coverage

Service
$0 copay
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Outpatient prescription drugs

Shared Health Dual Plus (HMO D-SNP) does not provide this type of benefit.

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Optional benefits

Shared Health Dual Plus (HMO D-SNP) does not provide this type of benefit.

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Medical equipment/supplies

Durable medical equipment (eg, wheelchairs, oxygen)
$0 copay
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Prosthetics (eg, braces, artificial limbs)
$0 copay
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Diabetes supplies
$0 copay
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Medicare Part B drugs

Chemotherapy
$0 copay
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Other Part B drugs
$0 copay
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Part B Insulin drugs
$0 copay
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Mental health services

Inpatient hospital - psychiatric
$0 copay
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Outpatient group therapy visit with a psychiatrist
$0 copay
Outpatient individual therapy visit with a psychiatrist
$0 copay
Outpatient group therapy visit
$0 copay
Outpatient individual therapy visit
$0 copay
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Preventive care

Service
$0 copay
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Rehabilitation services

Occupational therapy visit
$0 copay
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Physical therapy and speech and language therapy visit
$0 copay
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Additional Coverage Icon

Skilled Nursing Facility

Service
$0 copay
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Transportation

Service
$0 copay
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Vision

Routine eye exam
$0 copay
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Other
Not covered
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Contact lenses
$0 copay
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Eyeglasses (frames and lenses)
$0 copay
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Eyeglass frames
$0 copay
Limit Icon
Eyeglass lenses
$0 copay
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Upgrades
Not covered
Additional Coverage Icon

Wellness programs (eg, fitness, nursing hotline)

Service
Covered
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Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

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