A Healthy CollaborationSM

2009 Plans

Generations Healthcare Medicare Advantage Plans are an affordable way to manage your health and prescription drug coverage needs. Generations Healthcare Medicare Advantage Plans are available in Oklahoma City and Tulsa, Oklahoma. Plans offer low or no plan premiums, low co-pays, and deductibles, plus routine dental and vision coverage.

What plan is right for you?

Compare your Medicare Advantage and Medicare Advantage Prescription
Drug plan options below.

For more detailed information, review the Summary of Benefits.

Plan Summary - Oklahoma City

Value
Classic powered by CCRx
Premier powered by CCRx
Star powered by CCRx


Recommended for those who qualify for assistance from Medicaid.
Monthly Premium $0 plus a $39.20 reduction in monthly Part B premium $0 $46 $0
MEDICAL BENEFITS
Annual Out-of-Pocket Limit $3,000 $3,000 $2,500 Not Available
PCP/Specialist Co-pay $0/$25 $0/$25 $0/$15 20% coinsurance/
20% coinsurance
Inpatient Hospital Care $195 per stay $195 per stay $150 per stay $1,068 deductible per stay for days
1-60
Emergency Care Co-pay per visit $50 Worldwide Coverage $50 Worldwide Coverage $50 Worldwide Coverage 20% coinsurance (up to $50)
OTHER BENEFITS
Dental Benefits No Coverage No Coverage $15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays. Comprehensive dental benefits.
$15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays. $1,000 limit for preventive dental benefits. Comprehensive dental benefits
Vision Benefits No Coverage No Coverage $10 co-pay for annual exam; $20 co-pay for eyewear every year (up to $125) $10 co-pay for annual exam; $20 co-pay for eyewear every year (up to $125)
Over-the-Counter Benefit Not Available Not Available Not Available $20 a month for approved healthcare items
PART D PRESCRIPTION DRUG COVERAGE
Deductible No coverage $0 $0 $295 for brand drugs only
Initial Drug Coverage No coverage up to $2700 up to $2700 up to $2700
    31-day/90-day supply, you pay
Generics No coverage $0 $0 $5/$12.50
Preferred Brands No coverage $30/$75 $25/$62.50 $25/$62.50
Non-preferred Brands No coverage $60/$150 $50/$125 $50/$125
Specialty Drugs No coverage 25% 25% 25%
Coverage Gap Benefits No coverage No coverage $0 for generics $5/$12.50 for generics
Catastrophic Coverage after you reach $4,350 in out-of-pocket prescription drug expenses
    30-day/90-day supply, you pay
Generics No coverage The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40
Brands No coverage The greater of 5% coinsurance or $6 The greater of 5% coinsurance or $6 The greater of 5% coinsurance or $6
 

Plan Summary - Tulsa

Value
Classic powered by CCRx
Premier powered by CCRx
Star powered by CCRx


Recommended for those who qualify for assistance from Medicaid.
Monthly Premium $0 plus a $12.30 reduction in monthly Part B premium $15 $60 $0
MEDICAL BENEFITS
Annual Out-of-Pocket Limit $3,000 $3,000 $2,500 Not Available
PCP/Specialist Co-pay $15/$25 $15/$25 $0/$20 20% coinsurance/
20% coinsurance
Inpatient Hospital Care Days 1-5:
$250 per day
Days 1-5:
$250 per day
$175 per stay $1,068 deductible per stay for days
1-60
Emergency Care Co-pay per visit $50 $50 $40 20% coinsurance (up to $50)
OTHER BENEFITS
Dental Benefits $15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays.
$15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays.
$15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays. Comprehensive dental benefits.
$15 co-pay
(up to 2 visits/year), includes exam, cleaning, x-rays. $1,000 limit for preventive dental benefits. Comprehensive dental benefits
Vision Benefits $25 co-pay for annual exam; free eyewear every 2 years (up to $100) $25 co-pay for annual exam; free eyewear every 2 years (up to $100) $10 co-pay for annual exam; $20 co-pay for eyewear every year (up to $125) $10 co-pay for annual exam; $20 co-pay for eyewear every year (up to $125)
Over-the-Counter Benefit Not Available Not Available Not Available $20 a month for approved healthcare items
PART D PRESCRIPTION DRUG COVERAGE
Deductible No coverage $0 $0 $295 for brand drugs only
Initial Drug Coverage No coverage up to $2700 up to $2700 up to $2700
    31-day/90-day supply, you pay
Generics No coverage $5/$12.50 $0 $5/$12.50
Preferred Brands No coverage $30/$75 $20/$50 $25/$62.50
Non-preferred Brands No coverage $60/$150 $45/$112.50 $50/$125
Specialty Drugs No coverage 25% 25% 25%
Coverage Gap Benefits No coverage No coverage $0 for generics $5/$12.50 for generics
Catastrophic Coverage after you reach $4,350 in out-of-pocket prescription drug expenses
    30-day/90-day supply, you pay
Generics No coverage The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40 The greater of 5% coinsurance or $2.40
Brands No coverage The greater of 5% coinsurance or $6 The greater of 5% coinsurance or $6 The greater of 5% coinsurance or $6

Generations Healthcare is a member of the Universal American family of companies. For more information on Universal American, click here.


M0018_H3706_webr5_0609 (07/2009) Last updated: 7/10/2021

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