Plan Details
Network PlatinumPremier (PPO)
Ideal for those who prefer travel coverage.
_Premium
$195 per month
Enroll Now- $0 medical deductible
- $10 copayment for primary care provider visits
- $10 copayment for an annual eye exam
- $75 for hospital stays days 1-5 and $0 for additional days
- $3,400 maximum out-of-pocket (combined in- and out-of-network)
- 100% coverage for preventive care
- Travel coverage
- SilverSneakers® Fitness benefit
- Hearing aid discount benefit
- Annual dental exam and cleaning
Northeast Medicare Advantage PPO Plan Benefits
Network PlatinumPremier (PPO)
Combined in-and out-of-network
Per admission
including Ambulatory Surgical Center Services such as colonoscopies.
Copayment is waived if admitted to a U.S. hospital within 24 hours.
Per service
Such as MRIs, CT Scans
Diagnostic
Does not include services in connection with care, treatment, filling, removal or replacement teeth.
Includes comprehensive outpatient rehabilitation facility.
Manipulation of the spine to correct when one or more of the bones in your spine move out of position.
One Touch™ and Accu-Chek™ All other brands are not covered
Includes a one-year warranty, three office visits, one pack of batteries and one year of loss and damage insurance. Maximum of two hearing aids per year.
$1,220-$1,985 per device.
Save $775–$1,215 per hearing aid.
Eyewear Discounts
offered at EyeMed providers.
Network PlatinumPremier (PPO) Drug Plan Costs
This information is not a complete description of benefits. Call 800-378-5234 (TTY 800-947-3529) for more information. Out-of-network/non-contracted providers are under no obligation to treat Network Health members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.