Mary Washington Medicare Advantage Rewards (HMO)
Complete Coverage With One Plan PLUS $0 Premiums and Deductibles
Unlike traditional Medicare plans, Mary Washington Medicare Advantage bundles your medical, hospital and prescription drug coverage plus other valuable extra benefits in one comprehensive plan. Our Mary Washington Medicare Advantage Rewards plan includes $0 monthly premiums and NO deductibles to meet, and your coverage begins right away.
$51 Monthly Reduction on Your Part B Premium for Rewards Plan Members
One of the requirements for being on a Medicare Advantage plan is that you must also be enrolled in both Medicare Parts A and B, and Medicare Part B requires a monthly premium. Mary Washington Medicare Advantage is proud to offer Rewards Plan members a Shareback Plan—a significant cost-savings benefit which reduces your Medicare Part B premium by $51 per month!
Low Copay on Generic Prescriptions
Save even more money on your prescription drugs when you fill your prescription at preferred pharmacies. Mary Washington Medicare Advantage Rewards members can get generic, Tier 1, and Tier 2 prescriptions for low and reduced copays on brand-name medications at any participating preferred pharmacy.
Important Financial Protection
Mary Washington Medicare Advantage Rewards protects your savings and retirement by putting an annual limit on what you have to pay out of your own pocket for your covered medical expenses—important protection not offered by Original Medicare plans.
Important Travel Coverage
Whether you are making a trip out of the state or out of the country, we have you covered. If you ever get sick or injured when away from home, you can rest easy knowing you have emergency or urgent care coverage.
Valuable Extra Benefits That Save You Money
Mary Washington Medicare Advantage Rewards comes with important extra benefits for no additional premium such as preventive dental, vision, hearing and free memberships to health clubs through the popular SilverSneakers® program.
Benefits at a Glance:
We’ve Got You Covered From Head to Toe
The following table highlights just some of the many benefits available to you as a valued Mary Washington Medicare Advantage Rewards member. For more details and a complete list of benefits, please review our Summary of Benefits or Evidence of Coverage which can be downloaded by clicking the links below.
Medical & Hospital Coverage
Your Mary Washington Medicare Advantage Rewards plan provides comprehensive medical and hospital coverage with no annual deductible and low copayments.
| Mary Washington Medicare Advantage Rewards (HMO) | |
|---|---|
| Monthly Premium | $0 |
| Maximum Out-of-Pocket Limit | $5,600 Per Year |
| Annual Medical Deductible | $0 |
| Preventive Care/Screenings | $0 Copay |
| Primary Care Doctor Visists | $5 Copay |
| Specialty Care Doctor Visits | $50 Copay |
| Urgent Care | $35 Copay |
| Emergency Care | $110 Copay |
| Lab Services | $5 Copay |
| Home Healthcare | 100% Coverage |
| Chiropractic Services | $20 Copay |
| Inpatient Hospital Care | $345 Per Day for Days 1-7, $0 Per Day for Day 8 and Beyond |
| Outpatient Surgery at Hospital | $300 Copay |
| Outpatient Surgery at Ambulatory Surgery Center | $275 Copay |
Part D Drug Coverage
This table shows the drug tiers associated with your plan, and the copayments or co-insurance that you will pay in each tier. A drug formulary provides a list of drugs that are covered by our plan.
| Mary Washington Medicare Advantage Rewards (HMO) | ||
|---|---|---|
| Preferred Pharmacies |
Other Network Pharmacies |
|
| Annual Part D Deductible | $0 | $0 |
| Tier 1 - Preferrred Generics | $2 Copay* | $12 Copay* |
| Tiier 2 - Generics | $7 Copay* | $17 Copay* |
| Tier 3 - Preferred Brands | $42 Copay* | $47 Copay* |
| Tier 4 - Non-Preferred Brands | $95 Copay* | $100 Copay* |
| Tier 5 - Specialty Drugs | 33% Co-insurance* | 33% Co-insurance* |
| Initial Coverage Limit | $4,660 Per Year | $4,660 Per Year |
*All copay amounts shown are for a 30-day supply. Important—you won’t pay more than $35 for a one-month supply of each Part D insulin product covered by our plan, no matter the cost-sharing tier of the insulin product, the prescription drug coverage stage you are in (initial coverage, coverage gap, or catastrophic coverage), or your Extra Help status.
Extra Benefits
Your Mary Washington Medicare Advantage Rewards plan offers many valuable extras not offered by Original Medicare or Medicare supplement plans–at no additional cost to you.
| Mary Washington Medicare Advantage Rewards (HMO) | |
|---|---|
| Vision Care | $0 Copay for routine eye exam |
| Preventive Dental Visits | $35 Copay |
| Over-the-Counter (OTC) Items | Not Covered |
| Hearing | $35 Copay for routine or Medicare-covered hearing exam |
| Telehealth | Video visits with PCPs and select specialists—same copay as in‑office visits |
| Transportation Assistance | Not covered |
| SilverSneakers® Fitness Benefits | SilverSneakers® included at no cost |
| Travel Coverage | Emergency or urgent care coverage if you are making a trip out of state or country |
Extra benefit expenses are not covered under the maximum out-of-pocket limit.
