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# Central Health Medicare Plan
Monthly Premium$0
Annual Deductible$0
Annual Out of Pocket Maximum $2,995
Doctor Visit Copay
(Family\ Internal)
$0 per visit
Doctor Visit Copay
(Specialist)
$0 per visit
Urgent Care Visit Copay$0 per visit
Preventive Care$0 (Once Per Year)
Laboratory fee Copay$0 per visit
Inpatient Fee$0 per day for unlimited days
Outpatient Fee$0
Prescription Drug Fee$0/$5/$35/$75/33%
(Tier 1/2/3/4/5)
Emergency Room Visit Copay$50 ($0 if admitted within 24 hours)
Ambulance$40 per one-way trip
X Ray/Ultrasound$0
CT Scan/MRI Imaging$0
Plan detail information PDF
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〈Central Health〉
# MedicareComplete SecureHorizons Focus (HMO) MedicareComplete SecureHorizons Plan 2
Monthly Premium$0 $0
Annual Deductible$0 $0
Annual Out of Pocket Maximum $1,000$1,000
Doctor Visit Copay
(Family\ Internal)
$0 per visit $0 per visit
Doctor Visit Copay
(Specialist)
$0 per visit $0 per visit
Urgent Care Visit Copay$20 per visit$20 per visit
Preventive Care$0 (Once Per Year)$0 (Once Per Year)
Laboratory fee Copay$0 per visit $0 per visit
Inpatient Fee$0 per visit $0 per visit
Outpatient Fee$0$0
Prescription Drug Fee$2/$12/$47/$100/33%
(Tier 1/2/3/4/5)
$2/$12/$47/$100/33%
(Tier 1/2/3/4/5)
Emergency Room Visit Copay$90$90
Ambulance$225 per one-way trip$225 per one-way trip
X Ray/Ultrasound$0$0
CT Scan/MRI Imaging$50$50
Plan detail information PDF PDF
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〈UHC AARP〉
# Blue Shield 65 Plus Plan(HMO) Blue Shield Inspire(HMO)
Monthly Premium$0 $0
Annual Deductible$0 $0
Annual Out of Pocket Maximum $999 $999
Doctor Visit Copay
(Family\ Internal)
$0 per visit $0 per visit
Doctor Visit Copay
(Specialist)
$0 per visit $0 per visit
Urgent Care Visit Copay$5 per visit $0 per visit
Preventive Care$0 (Once Per Year)$0 (Once Per Year)
Laboratory fee Copay$0 per visit $0 per visit
Inpatient Fee$150 per visit $150 per visit
Outpatient Fee$0$0
Prescription Drug Fee$0/$5/$38/$95/33%/$5
(Tier 1/2/3/4/5/6)
$0/$3/$35/$90/33%/$5
(Tier 1/2/3/4/5/6)
Emergency Room Visit Copay$85$85
Ambulance$150 per one-way trip$100 per one-way trip
X Ray/Ultrasound$0$0
CT Scan/MRI Imaging$20$75
Hearing AidsCoveredCovered
SilverSneakers Fitness$0$0
Plan detail information PDF PDF
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〈Blue Shield〉
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