Available to residents of Washoe County, Storey County, and Carson City.
The Select Plan has a maximum out-of-pocket of just $1,450 per year, making it a great choice for individuals who frequently access health care. The Select Plan has $0 Primary Care office visits and Specialist office visits for just $5. While not for everyone because of the $180 monthly premium, the Select Plan can be a real money saver for certain Medicare beneficiaries.
| Benefits Included | Pricing |
|---|---|
| PRIMARY CARE VISIT | $0 Per visit (preferred PCP) $10 per visit (non preferred PCP) |
| SPECIALIST VISIT | $5 per visit |
| ROUTINE LAB SERVICES | $0 per visit |
| URGENTLY NEEDED CARE | $20 / $45 per visit ($0 Teladoc) |
| OVER-THE-COUNTER BENEFIT | $140 Quarterly |
| DENTAL COVERAGE | $1,500 Comprehensive first-dollar coverage |
| Doctors & Hospitals | Amount You Will Pay |
|---|---|
| Maximum Out-of-Pocket | $1,450 per year |
| Primary Care Office Visit | $0 Per visit (preferred PCP) $10 per visit (non preferred PCP) |
| Specialist Office Visits | $5 per visit |
| Urgently Needed Care | $20 / $45 per visit ($0 Teladoc) |
| Routine Lab Services | $0 per visit |
| Diagnostic Tests (X-ray, CT, MRI) | $45 / $65 / $90 per visit |
| Emergency Room Care | $140 per visit |
| Ambulance Services | $250 per trip |
| Inpatient Hospital | Preferred: $175 (1-2days) Non-Preferred: $440 (1-5 days) |
| Outpatient Hospital Services | Preferred: $175 per visit Non-Preferred: $440 per visit |
| Prescription Coverage | Amount You Will Pay for Preferred Medications |
|---|---|
| Coverage in the Gap | N/A |
| Rx Deductible | N/A |
| Preferred Generic (Tier 1) | $0 Per Prescription |
| Non-Preferred Generic (Tier 2) | $0 Per Prescription |
| Preferred Brand (Tier 3) | $47 Per Prescription $35 each covered insulin product |
| Non-Preferred Brand (Tier 4) | 50% Coinsurance |
| Specialty Drugs (Tier 5) | 33% coinsurance |
| Select Drug (Tier 6) | $0 Per Prescription |
| 90-day Retail / 90-day Mail Order | 2.5 times 30-day / 2 times 30-day |
The Select Plan is Senior Care Plus’s most benefit-rich plans with the lowest out-of-pocket maximum of any of our plans. With $0 Primary Care visits and $5 Specialist visits, the Select Plan offers great value for Medicare beneficiaries with high healthcare utilization. The Select Plan has $1,500 first-dollar comprehensive dental benefit from Liberty Dental and a $140 quarterly Over-the-Counter benefit with free two-day shipping. 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 Select Plan is extensive, and includes select insulins at $35.
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.
