PLAN HIGHLIGHTS

THE ESSENTIAL PLAN

Enroll With Senior Care Plus

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  • Prescription Drug Coverage

  • Routine Vision Coverage

  • Hearing Coverage

  • Over-the-Counter Benefit

  • Preventive Dental

Essential Plan

Available to residents of Washoe County and Carson City.

$0/mo

The Essential Plan offers residents of Washoe County and Carson City a wide variety of choices when it comes to providers, with $0 monthly premium.

Benefits Include:

Primary Care Visit $0 / $10 per visit
Specialist Visit $50 per visit
Routine Lab Services $0 per visit
Urgent Care & DispatchHealth $30 / $65 per visit ($0 Teladoc)
Over-the-Counter Benefit $25 Quarterly
Dental Coverage Closed Network Preventive
How to enroll
All Northern Nevada Plans
Doctors & Hospitals Amount You Will Pay
Maximum Out-of-Pocket $3,400 per year
Primary Care Office Visit $0 / $10 per visit
Specialist Office Visits $50 per visit
Urgent Care Visit $30 / $65 per visit ($0 Teladoc)
Routine Lab Services $0 per visit
Diagnostic and X-Ray $70 / $100 / $135 per visit
Emergency Room Care $120 per visit
Ambulance Services $250 per trip
Inpatient Hospital In-Network: $275 / 5 days per period; Out-of-Network: $440 / 5 days per period
Outpatient Hospital Services $275 / $440 per visit
Prescription Coverage Amount You Will Pay
Coverage in the Gap $2.50 (Tier 6)
Rx Deductible No deductible
Preferred Generic (Tier 1) $5 (30-day)
Non-Preferred Generic (Tier 2) $12 (30-day)
Preferred Brand (Tier 3) $41 (30-day)
Non-Preferred Brand (Tier 4) $94 (30-day)
Specialty Drugs (Tier 5) 33% coinsurance
Select Drug (Tier 6) $2.50 (30-day)
90-day Retail / 90-day Mail Order 2.5 times 30-day / 2 times 30-day

Amount you will pay is listed as “in-network / out-of-network”.

Our Network
Essential Plan members can choose to see any community provider including priority access to Renown Health providers and facilities.

provider directories

Fitness Benefit
Members on the Essential Plan receive a year-long gym membership at one participating gym facility.

participating gyms

Over-the-Counter (OTC) Benefit
Members on the Essential Plan receive a $25 quarterly over-the-counter to use toward qualifying over-the-counter medications, health supplies and more.

view the otc catalog

Amount you will pay is listed as “in-network / out-of-network”

Summary

The Essential Plan is the right option for you if your primary care physician is not a Renown provider. The Essential Plan includes the entire Senior Care Plus network of doctors and specialists, including priority access to Renown Health facilities.
Enjoy the added perks of a gym benefit, preventive dental, over-the-counter (OTC) allowance, vision, and hearing aid coverage. Personal Assistants, who can help schedule appointments and navigate the healthcare system are included when you select a Renown Primary Care Provider (PCP).

Above is a partial list of benefits and should not be construed as a complete list. Please refer to the Evidence of Coverage in the plan documents section above for a complete list of benefits.

Out-Of-Network Providers: If you use an out-of-network provider, your share of the costs for your covered services may be higher. Out-of-network providers are under no obligation to treat members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. 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.

Enroll With Senior Care Plus

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Senior Care Plus
A Medicare Advantage organization from Hometown Health