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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.

Are you protected? Find out.

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.

Learn more about all of our extra benefits.


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 (What's this?) $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
$0 Copay for a pair of eyeglass frames
$100 allowance for frames or contacts

Preventive Dental Visits

$35 Copay

Over-the-Counter (OTC) Items

Not Covered

Hearing

$35 Copay for routine or Medicare-covered hearing exam
No hearing aid coverage

Telehealth

Video visits with PCPs and select specialists—same copay as in‑office visits

Transportation Assistance

Not covered

SilverSneakers® Fitness Benefits (What's this?)

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.


Important Plan Documents

Summary of Benefits Updated: 10/01/2022
Annual Notice of Change Updated: 10/01/2022
Evidence of Coverage Updated: 10/01/2022
Star Ratings Updated: 10/01/2022
Drug Formulary Updated: 10/01/2022
Calificaciones por Estrellas Actualizado: 01/10/2022
Provider Directory Updated: 10/01/2022
Formulary Change Notice Updated: 10/01/2022
Low Income Subsidy Premiums Updated: 10/01/2022

Interested in Learning More About a
Mary Washington Medicare Advantage (HMO) Plan?

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