Medicare Advantage Plan Comparison without Drug Coverage.

The Benefit Comparison Chart below provides an overview of the most commonly used benefits, and the coverage and cost differences between our Medicare Advantage plans. Use this to help find the plan that offers the benefits that are most important to you.

Plans Without Prescription Drug Coverage

  Ascent (HMO) Alpine (HMO)
Monthly Premium $0 $39
Maximum Out of Pocket Expense $3400 $2250
Annual Preventive Exam Copay $0 $0
Primary Care Visit Copay $10 $10
Specialist Visit Copay $40 $30
Inpatient Hospital Copay

$275 Copay per day for days 1-8;

$0 Copay for additional days

$200 Copay per day for days 1-5;

$0 Copay for additional days
Emergency Care Copay $50 $50
Routine Vision Care $0 Copay for an annual routine eye exam from a participating provider; $120 allowance toward the purchase of vision hardware from a participating provider every 12 months with a $15 Copay $0 Copay for an annual routine eye exam from a participating provider; $120 allowance toward the purchase of vision hardware from a participating provider every 12 months with a $15 Copay
Routine Transportation Not Covered 20 one-way trips $0 Copay
Silver&Fit Program Included Included
   

 

Benefits Comparison Chart*

*Covered services must be provided by a Soundpath Health network provider or pharmacy for benefits to apply.  To view the Soundpath Health Evidence of Coverage documents, click here.