Aspire Health Plus (HMO-POS)
Medicare Advantage Health Plan Details
Health insurance company offering plan: Aspire Health
- Rx
General Plan Details
Additional Benefits
Doctor & Hospital Coverage
Out-of-network: 30% coinsurance
Out-of-network: 30% coinsurance
Out-of-network: $0 copay
Emergency Room
$115 copay
Ambulance Coverage
In-network: $325 copay
Out-of-network: $325 copay
Lab, X-Ray, Radiology Coverage
Diagnostic tests & procedures:
In-network: $0 copay
Out-of-network: 30% coinsurance
Lab services:
In-network: $0 copay
Out-of-network: 30% coinsurance
Diagnostic radiology services (e.g., CT, MRI, etc):
In-network: $30-$100 copay
Out-of-network: 30% coinsurance
Outpatient x-rays:
In-network: $0 copay
Out-of-network: 30% coinsurance
Hospital Services
Inpatient hospital coverage:
In-network:
Tier 1
$550 per day for days 1-2
$250 per day for days 3-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
30% per day for days 1-90
30% per stay
Outpatient hospital coverage:
In-network: $40-$200 copay
Out-of-network: 30% coinsurance
Rehabilitation Coverage
Occupational therapy services:
In-network: $0 copay
Out-of-network: 30% coinsurance
Urgent Care Coverage
$115 copay
Skilled Nursing Facility (SNF)
In-network:
Tier 1
$0 per day for days 1-20
$100 per day for days 21-100
Out-of-network:
30% per day for days 1-100
30% per stay
Mental Health Coverage
Outpatient group therapy with a psychiatrist:
In-network: $0 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy with a psychiatrist:
In-network: $0 copay
Out-of-network: 30% coinsurance
Outpatient group therapy visits:
In-network: $0 copay
Out-of-network: 30% coinsurance
Outpatient individual therapy visit:
In-network: $0 copay
Out-of-network: 30% coinsurance
Dental, Vision, Hearing Benefits
Rx Drug Coverage - Standard Retail Cost
Tier 1: Preferred Generic
$0.00 copay (30-day supply)
$0.00 copay (90-day supply)
Tier 2: Generic
$10.00 copay (30-day supply)
$30.00 copay (90-day supply)
Tier 3: Preferred Brand
$45.00 copay (30-day supply)
$135.00 copay (90-day supply)
Tier 4: Non-Preferred Drug
25% coinsurance (30-day supply)
Tier 5: Specialty Tier
33% coinsurance (30-day supply)
Additional Added Benefits
Plan Links
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