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IH

Inspira Health Network LIFE

Plan ID: H6887-1-0

Inspira Health Network LIFE (PACE)

2024 Inspira Health Network LIFE (PACE) H68870010 is a Medicare Advantage plan with drug coverage.

Learn more about Inspira Health Network LIFE (PACE) H6887 - 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.

$371.40 /mo

Monthly premium

$0

Health deductible

$0

Drug deductible

$0

Out-of-pocket maximum

Enroll online

Call to enroll

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

Overview Icon

Plan Overview

2024 Inspira Health Network LIFE (PACE) H68870010 is a National PACE offered in Inspira Health Network LIFE by Inspira Health Network LIFE. It has a monthly premium of $371.40.

Premium Breakdown

Standard Part B Premium

$174.70

Part B premium reduction

- $0

Monthly Plan Premium

$371.40

Total Premium:

$546.10

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

No

Out-of-pocket maximum

$0

Plan Organization:

Inspira Health Network LIFE

Plan Type:

National PACE

Location:

Inspira Health Network LIFE

Drugs Covered:

Yes

Drug Formulary:

Pharmacies:

Doctor Choice:

Plan Doctors for Most Services

Doctors Link:

Not yet released

Deductibles

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

Health deductible

$0

Drug deductible

$0

Sign up for Inspira Health Network LIFE (PACE)

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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

Inspira Health Network LIFE (PACE) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Benefit Type

Prescription drug deductible

$0

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

$371.40

$371.40

$371.40

$371.40

$371.40

Initial Coverage Phase

After you pay your $0.00 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

-

-

-

-

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)

Dental Icon

Additional Benefits

Inspira Health Network LIFE (PACE) also provides the following benefits.

Note:

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

Additional Coverage Icon

Comprehensive dental

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

Preventive dental

Oral exam
Not covered
Limit Icon
Cleaning
Not covered
Limit Icon
Fluoride treatment
Not covered
Limit Icon
Dental x-ray(s)
Not covered
Limit Icon
Additional Coverage Icon

Diagnostic procedures/lab services/imaging

Diagnostic tests and procedures
Not Applicable
Lab services
Not Applicable
Diagnostic radiology services (eg, MRI)
Not Applicable
Outpatient x-rays
Not Applicable
Additional Coverage Icon

Doctor visits

Primary
Not Applicable
Specialist
Not Applicable
Additional Coverage Icon

Emergency care/Urgent care

Emergency
Not Applicable
Urgent care
Not Applicable
Additional Coverage Icon

Foot care (podiatry services)

Foot exams and treatment
Not Applicable
Routine foot care
Not covered
Additional Coverage Icon

Ground ambulance

Service
Not Applicable
Additional Coverage Icon

Hearing

Hearing exam
Not Applicable
Fitting/evaluation
Not covered
Limit Icon
Hearing aids - inner ear
Not covered
Limit Icon
Hearing aids - outer ear
Not covered
Limit Icon
Hearing aids - over the ear
Not covered
Limit Icon
Additional Coverage Icon

Inpatient hospital coverage

Service
Not Applicable
Additional Coverage Icon

Outpatient hospital coverage

Service
Not Applicable
Additional Coverage Icon

Outpatient prescription drugs

Inspira Health Network LIFE (PACE) does not provide this type of benefit.

Additional Coverage Icon

Optional benefits

Inspira Health Network LIFE (PACE) does not provide this type of benefit.

Additional Coverage Icon

Medical equipment/supplies

Durable medical equipment (eg, wheelchairs, oxygen)
Not Applicable
Prosthetics (eg, braces, artificial limbs)
Not Applicable
Diabetes supplies
Not Applicable
Additional Coverage Icon

Medicare Part B drugs

Chemotherapy
Not Applicable
Other Part B drugs
Not Applicable
Part B Insulin drugs
Not Applicable
Additional Coverage Icon

Mental health services

Inpatient hospital - psychiatric
Not Applicable
Outpatient group therapy visit with a psychiatrist
Not Applicable
Outpatient individual therapy visit with a psychiatrist
Not Applicable
Outpatient group therapy visit
Not Applicable
Outpatient individual therapy visit
Not Applicable
Additional Coverage Icon

Preventive care

Service
$0 copay
Additional Coverage Icon

Rehabilitation services

Occupational therapy visit
Not Applicable
Physical therapy and speech and language therapy visit
Not Applicable
Additional Coverage Icon

Skilled Nursing Facility

Service
$0 copay per stay
Additional Coverage Icon

Transportation

Service
Not covered
Additional Coverage Icon

Vision

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

Wellness programs (eg, fitness, nursing hotline)

Service
Not covered
Overview Icon

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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