PLAN HIGHLIGHTS

EXTENSIVE DUALS PLAN

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Questions?  Call us at 775-982-3158

See The Provider Directory Here
See The Formulary & Pharmacy Benefits here
  • $2,000 first dollar dental coverage 

  • $190 Quarterly Over-the-Counter (OTC) Benefit 

  • $0 Premium & $0 Preferred PCP visits 

  • $0 Hearing Exams & Vision Exams 

  • Fitness Benefit with select gyms 

  • Generous Prescription Drug Benefit 

Extensive Duals Plan

Available to residents in Washoe County and Carson City with Medicare and Medicaid.

$0/mo

If you reside in Washoe County or Carson City and have Medicare AND Medicaid,  the Extensive Duals Plan is outstanding, benefit-rich option you should consider. The Extensive Duals Plan members enjoy priority access to Renown and in many cases, Medicaid covers the premium and copay amounts.  

Benefits Include:

Primary Care Visit 20% per visit
Specialist Visit 20% per visit
Routine Lab Services $0 per visit
Urgently Needed Care / Teladoc 20% per visit
Over-the-Counter Benefit $190 Quarter
Dental COVERAGE $2,000 Comprehensive Included

Copayments listed are for preferred facilities.

How to enroll
All Northern Nevada Plans
Doctors & Hospitals Amount You Will Pay
Maximum Out-of-Pocket $8,300 per year
Primary Care Office Visit 20% per visit
Specialist Office Visits 20% per visit
Urgently Needed Care / Teladoc 20% per visit
Routine Lab Services $0 per visit
Diagnostic Tests (X-ray, CT, MRI) 20% per test
Emergency Room Care 20% per visit
Ambulance Services 20% per trip
Inpatient Hospital $1,484 Deductible $0 days 1-60 $371 days 61-90
Outpatient Hospital Services 20% per visit
Prescription Coverage Amount You Will Pay for Preferred Medications
Rx-Annual Deductible N/A
Coverage in the Gap N/A
Preferred Generic (Tier 1) Generic $4.15
Non-Preferred Generic (Tier 2) Generic $4.15
Preferred Brand (Tier 3) Brand $10.35
Non-Preferred Brand (Tier 4) Brand $10.35
Specialty Drugs (Tier 5) 33% coinsurance
Select Drug (Tier 6) Generic $4.15 Brand $10.35

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

Healthy Me 2023 Benefits Brochure 

See all the new 2023 benefits in the Healthy Me 2023 Benefits Brochure – includes OTC Catalog and Dental Directory 

2023 Benefits Brochure

Priority Access to Renown Health 

Extensive Dual Plan members can choose to see any community provider including priority access to Renown Health providers and facilities. 

Provider Directories

 Virtual Visits 

Senior Care Plus members have two options when accessing virtual care: Renown Health virtual visits (for urgent, primary and specialty care) and Teladoc (for urgent care and dermatology). 

Virtual Visit Options

Summary

The Extensive Duals Plan offers individuals that have Medicare Part A and Part B and also qualify for Medicaid in the state of Nevada additional benefits that are not covered on their existing programs.  Senior Care Plus works with the Nevada Medicaid program to ensure coordination of member’s benefits.   The plan’s $32.70 premium is covered by Medicaid for most members, as well as many of the other out-of-pocket costs.. 

The Extensive Duals Plan has been enhanced in 2023 with an updated hearing benefit from NationsHearing® that includes a $0 hearing exam and a generous hearing aid benefit.  NationsOTC® provides a $190 quarterly Over-the-Counter benefit with free two-day shipping.   

The Extensive Duals Plan has also added $2,000 first dollar comprehensive dental benefit from Liberty Dental. And once you enroll, you will have access to a Personal Assistant, who can help schedule appointments and navigate the healthcare system if you select a Renown Primary Care Provider (PCP). 

The prescription drug coverage included in the Extensive Duals Plan is comprehensive, and includes select insulins at the $35 Senior Savings Program cost. 

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 complete plan details. 

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. 

 

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Senior Care Plus
A Medicare Advantage organization from Hometown Health

Material ID: H2960_2023_SCPWebsite1_M (CMS Accepted)

Last updated:  November 4 2022