2012 BENEFIT DESIGN- HUMANA MEDICARE ADVANTAGE PLAN
Plan Comparison changes from 2011 to 2012
2011 2012
Premium $59 per month $55 per month
Deductible None None
Physician $15 Copay $15 Copay
Specialist $35 Copay $40 Copay
Inpatient $225 Copay per day 1-7 $225 Copay per day 1-7
Hospital
Outpatient $200 Copay per visit $150 Copay per visit
Surgical
Ambulatory $150 Copayment $100 Copayment
Surgical Center
Skilled Nursing 100% days 1-8 100% days 1-14 No three day hospital stay required
DME 80% 85%
Ambulance $150 Copay $100 Copay
Emergency Room $50 Copay $65 Copay
Urgent Care $35 Copay $40 Copay
Pharmacy 30 day $8/$8/$30/$84/33% $7/$42/$82
Pharmacy 90 day $0/$0/$110/$242 $0//$116/$236
Mail Order
Out of Pocket $5000/$7000 $5000/$7000
Maximum
Preventive Services covered at 100% for Plan year 2012
Routine physical (one per year)
Diabetes self-management
Nutrition therapy (ESRD or diabetic patients)
Bone mass measurement (one per year)
Colorectal screening (one per year)
Pap smear, pelvic exam, and prostate cancer screening (one per year)
Mammography screening (one per year)
Smoking cessation (Medicare covered)
Immunizations
Abdominal aortic aneurysm screening (one per year)
Cardiovascular disease testing (one per year)
Glaucoma screening (one per year)
HIV screening (one per year)
EKG screening (one per year)
Diabetes screening (one per year)
Kidney disease education services