Compare 2009
Optima Medicare (PPO)
Plans
Please use the charts below to compare 2009 Optima Medicare Plans.
You can choose an Optima Medicare Preferred Plan with a modest premium, or an Optima Medicare Value Plan with $0 monthly premium.
If you want prescription drug coverage choose either an Optima Medicare Preferred Plus or an Optima Medicare Value Plus plan.
You can download a printable version of these charts for your reference.
Download a printable version of these charts
2009 Optima Medicare Value Plans -- $0 Monthly Premium
|
Optima Medicare
Value |
Optima Medicare
Value Plus |
| Monthly Premium |
$0 |
$0 |
| Annual Medical Out-Of-Pocket Limit |
$3,250 |
$3,250 |
| Benefits |
Network |
Out-Of-Network |
Network |
Out-Of-Network |
| Inpatient Hospital Care |
$125 per day (1-5) |
$125 per day (1-5) |
$185 per day (1-5) |
$185 per day (1-5) |
| Doctor Office Visits |
$10 per visit |
20% |
$10 per visit |
30% |
| Physical Exams |
$10 per annual exam |
20% |
Not Covered |
Not Covered |
| Emergency Care |
$50 per visit |
$50 per visit |
$50 per visit |
$50 per visit |
| Urgent Care |
$10 per visit |
$10 per visit |
$10 per visit |
$10 per visit |
| Part D Prescription Drugs |
Not Covered |
Not Covered |
$4/$30/$60/30% |
$4/$30/$60/30% |
H4908_SEN_COMPARE09_CMS Approved 072808
You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
2009 Optima Medicare Preferred Plans
|
Optima Medicare
Preferred |
Optima Medicare
Preferred Plus |
| Monthly Premium |
$84 |
$116 |
| Annual Medical Out-Of-Pocket Limit |
$3,000 |
$3,000 |
| Benefits |
Network |
Out-Of-Network |
Network |
Out-Of-Network |
| Inpatient Hospital Care |
$0 |
$500 per admission |
$0 |
$500 per admission |
| Doctor Office Visits |
$10 per visit |
$15 per visit |
$10 per visit |
$15 per visit |
| Physical Exams |
$0 per annual exam |
$15 per annual exam |
$0 per annual exam |
$15 per annual exam |
| Emergency Care |
$50 per visit |
$50 per visit |
$50 per visit |
$50 per visit |
| Urgent Care |
$10 per visit |
$10 per visit |
$10 per visit |
$10 per visit |
| Part D Prescription Drugs |
Not Covered |
Not Covered |
$4/$30/$60/30% |
$4/$30/$60/30% |
H4908_SEN_COMPARE09_CMS Approved 072808
You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party.
For more information about any of our Medicare Plans, please call 1-866-806-0333.
What Would You Like to Do Now?
Enroll Now -- a Medicare Advisor can help,
call toll-free 1-866-806-0333 (TTY/TTD 1-800-225-7784)
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Request a free Enrollment Kit and Decision Guide
* This form is only intended as a snapshot comparison of Optima Medicare plans. For a complete summary, please refer to the Summary of Benefits documents provided by Optima, or view them at www.optimahealth.com/medicare or on the CMS website for health plan comparison information at http://www.medicare.gov/.
Except for emergencies and urgent care, the use of non-plan providers or non-participating network pharmacies may cost more. Please go to www.optimahealth.com/medicare for a list of providers and network pharmacies, or call 1-800-927-6048 (TTY users: 1-800-225-7784) seven days a week, 8 a.m.– 8 p.m.
If you have questions about Medicare benefits, including general information regarding health or Part D benefits, you can call 1-800-MEDICARE (1-800-633-4227); TTY/TDD users should call 1-877-486-2048, 24 hours a day, seven days a week. You can also visit http://www.medicare.gov/.
Optima Health Insurance Company has a contract with the federal government to provide Medicare Part D benefits to people with Medicare in many cities and counties in Virginia. Benefits, formulary, pharmacy network, premium and/or co-payments or coinsurance may change January 1, 2010. Please contact Optima Health for details.
Optima Medicare Preferred, Optima Medicare Preferred Plus, Optima Medicare Value and Optima Medicare Value Plus are Medicare Advantage Preferred Provider Organizations (PPO) plans with a Medicare contract.
By law, Optima Health can refuse to renew its contract with CMS, and CMS also may refuse to renew the contract. Termination or nonrenewal may result in termination of the beneficiary’s enrollment in the plans. In addition, the plan may reduce its service area and no longer offer services in the area where the beneficiary resides.
Optima Medicare Preferred, Optima Medicare Preferred Plus, Optima Medicare Value and Optima Medicare Value Plus are underwritten by Optima Health Insurance Company.