H6528 031

Get 2024 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC

H6528 031. Copayment for Non-Medicare Covered Podiatry Services $50.00. Skilled Nursing Facility (SNF) care. In-Network: Skilled Nursing Facility Services: $0.00 per day for days 1 to 20. $196.00 per day for days 21 to 40. $0.00 per day for days 41 to 100. Prior Authorization Required for Skilled Nursing Facility Services.

H6528-041-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m.-8 p.m. local time, 7 days a week AARPMedicarePlans.com Y0066_SB_H6528_041_000_2023_M

Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC Copayment for Medicare Covered Primary Care Office Visit $35.00. Specialty doctor visit. Out-of-Network: Doctor Specialty Visit: Copayment for Medicare Covered Physician Specialist Office Visit $70.00. Inpatient hospital care. Out-of-Network: $500.00 per day for days 1 to 18. $0.00 per day for days 19 to 999. 4 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H2228-068-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $28.00 Monthly Premium.Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCEffective July 1, 2023, cost sharing for covered Part B Insulin furnished through a covered item of durable medical equipment will be no more than $35 for a one-month (up to 30-day) supply and if your plan has a deductible, it does not apply to Part B Insulin. Part B Insulin is most commonly used through an insulin pump.Providing 2023 Medicare Plan Star Rating Details and detailed information on the Medicare Part D prescription drug and Medicare Advantage plans for every state, including Medicare Part D plan features and costs. Free Medicare Part D Newsletter, Use the Online Caculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLCAvailable online provider directories (PDF): CALIFORNIA 州 ALAMEDA 縣 Aetna Medicare Select Plan (HMO)_H0523-068. CALIFORNIA 州 SAN FRANCISCO 市 Aetna Medicare Select Plan (HMO)_H0523-070. CALIFORNIA 州 ALAMEDA 縣 SAN FRANCISCO 市 Aetna Medicare Value Plus Plan (HMO-POS)_H0523-076.

Get free real-time information on BRL/RUB quotes including BRL/RUB live chart. Indices Commodities Currencies StocksPassionate buyers are opting out of the modern housing market in favor of homes from centuries past that need a little love to survive. By clicking "TRY IT", I agree to receive new...H6528-031-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m.-8 p.m. local time, 7 days a week AARPMedicarePlans.com Y0066_SB_H6528_031_000_2023_MShould Brett Kavanaugh and Samuel Alito have met with a conservative advocate whose organization has filed a brief on controversial cases that remain open? Just how friendly should...Out-of-Network: Doctor Specialty Visit: Copayment for Medicare Covered Physician Specialist Office Visit $70.00. Inpatient hospital care. In-Network: Acute Hospital Services: $250.00 per day for days 1 to 6. $0.00 per day for days 7 to 90. Prior Authorization Required for Acute Hospital Services. H6528 - 031 - 0 Click to see other plans: Member Services: 1-877-370-4874 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.

HA antibody | Sigma-AldrichThere's no limit to the number of medically necessary inpatient hospital days. $50 per day for days 1-5 of your stay and $0 for the rest of your stay. $0. Outpatient hospital coverage. $0–$120 per visit. $0–$120 per visit. Ambulatory Surgery Center.R5342:006-0 UHC Medicare Advantage NY-0022 (Regional PPO) R6801:012-0 UHC Medicare Advantage TX-0030 (Regional PPO) R7444:001-0 AARP Medicare Advantage from UHC NG-0001 (Regional PPO) Compare the 600 Medicare Advantage plans available from UnitedHealthcare through Alight Retiree Health Solutions.AARP Medicare Advantage Choice Rebate (PPO) is a Medicare Advantage (Part C) Plan by UnitedHealthcare. This page features plan details for 2023 AARP Medicare Advantage Choice Rebate (PPO) H6528 – 041 – 0 available in Select Counties in Georgia. IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link ...Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC 2023 AARP Medicare Advantage Choice (PPO) - H6528-031-0 in AR Plan Benefits Details

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Login. All the tools and resources you need to succeed are here. Get quotes, compare plans, submit applications, manage clients and more from your laptop, tablet or Smartphone. 3.5 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice Plan 2 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H6528-035-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $35.00 Monthly Premium. Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCGet 2021 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC 3.5 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice Plan 2 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H6528-035-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $35.00 Monthly Premium. H6528 - 041 - 0 (3.5 / 5) AARP Medicare Advantage Choice Rebate (PPO) is a Medicare Advantage (Part C) Plan by UnitedHealthcare. Premium: $0.00 Enroll Now This page features plan details for 2023 AARP Medicare Advantage Choice Rebate (PPO) H6528 – 041 – 0 available in Select Counties in Georgia.

First Sensor News: This is the News-site for the company First Sensor on Markets Insider Indices Commodities Currencies Stocks4 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H2228-030-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $29.00 Monthly Premium. 2023 Medicare Advantage Plan Details. — This plan information is for research purposes only. Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. This plan has a $55 Part B monthly premium rebate (or giveback). However, you must continue to pay your Medicare Part B premium. Copayment for Medicare Covered Primary Care Office Visit $35.00. Specialty doctor visit. Out-of-Network: Doctor Specialty Visit: Copayment for Medicare Covered Physician Specialist Office Visit $70.00. Inpatient hospital care. Out-of-Network: $500.00 per day for days 1 to 18. $0.00 per day for days 19 to 999.Get 2021 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCAARP Medicare Advantage Choice (PPO) Location: Boone, Arkansas Click to see other locations. Plan ID: H6528 - 031 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711. — This plan information is for research purposes only. Click here to see plans for the current plan year.From flying high above the mountains, to paddling through North America's deepest river gorge. There’s a famous saying in the ski community of Sun Valley that goes, “The higher you...H6528 - 006 - 0 Click to see other plans: Member Services: 1-800-204-1002 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.2021 Medicare Advantage Plan Benefits explained in plain text. Plain text explanation available for any plan in any state. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, IncYou need to enable JavaScript to run this app.

H6528 - 033 - 0 Click to see other plans: Member Services: 1-877-370-4874 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.

Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCWhy do people create fake profiles of people suspected of mass violence? It’s become the norm in the United States that when a suspect is named in a high-profile violent incident, ...Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Choice (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible:Health & Family Welfare Department, Government of Himachal Pradesh. HIMACHAL PRADESH.4 out of 5 stars* for plan year 2024. AARP Medicare Advantage from UHC OH-0004 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H8768-014-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium.I’ll explain the differences between a cruise ship cabana and a private island cabana, then get down to the details of what each major cruise line offers and how much a day in a ca...When candles get dusty or grimy, it’s tough to get them clean with a simple duster or wet cloth. Rubbing alcohol will do the job nicely, though. When candles get dusty or grimy, it...AARP Medicare Advantage Choice (PPO) Location: Sebastian, Arkansas Click to see other locations. Plan ID: H6528 - 031 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711. — This plan information is for research purposes only. Click here to see plans for the current plan year.

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Non è possibile visualizzare una descrizione perché il sito non lo consente.In-Network: Copayment for Medicare-Covered Podiatry Services $30.00. Copayment for Routine Foot Care $30.00. Maximum 6 visits every year. Skilled Nursing Facility Care. $0 per day, days 1-20. $203 per day, days 21-100 in-network, for more information see Evidence of Coverage.Copayment for Medicare Covered Primary Care Office Visit $35.00. Specialty doctor visit. Out-of-Network: Doctor Specialty Visit: Copayment for Medicare Covered Physician Specialist Office Visit $70.00. Inpatient hospital care. Out-of-Network: $500.00 per day for days 1 to 18. $0.00 per day for days 19 to 999.How does a clothes steamer work? Find out more about clothes steamers at HowStuffWorks.com. Advertisement Most high school history teachers and "Jeopardy!" participants would proba...If you like to do any woodworking, you’re probably aware of the eyesore that screws can be. This method lets you attach wood together with screws, but keeps the screw head hidden f...4 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice Plan 1 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H2228-037-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $43.00 Monthly Premium.Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCWhy do people create fake profiles of people suspected of mass violence? It’s become the norm in the United States that when a suspect is named in a high-profile violent incident, ...Discover the Benefits. Dental benefits. $1,250 dental allowance for covered preventive and comprehensive services like cleanings, fillings and crowns. OTC Credit. $40 credit every quarter for OTC products like pain relievers, cold remedies and vitamins in-store or online. Routine vision benefits.2023 Medicare Advantage Plan Details. — This plan information is for research purposes only. Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. This plan has a $55 Part B monthly premium rebate (or giveback). However, you must continue to pay your Medicare Part B premium. Medicare Advantage Plans. Available to AARP members and non-members. Plans and pricing are on the UnitedHealthcare website. Medicare Advantage plans offer additional benefits not covered by Original Medicare. You'll leave AARP.org and go to the website of a trusted third-party. The third-party's terms, conditions, and policies apply. ….

Providing detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCProviding detailed information on the Medicare Part D program for every state, including selected Medicare Part D plan features and costs organized by State. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCHow does a clothes steamer work? Find out more about clothes steamers at HowStuffWorks.com. Advertisement Most high school history teachers and "Jeopardy!" participants would proba...2024 AARP Medicare Advantage Choice (PPO) - H6528-033-0 in AL Plan Benefits DetailsMedicare Plans. UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO) 3.5 out of 5 stars* for plan year 2023. UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO) is … We would like to show you a description here but the site won’t allow us. H6528-006-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCMedicareSolutions.com Y0066_SB_H6528_006_000_2022_MH6528-031-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m.-8 p.m. local time, 7 days a week AARPMedicarePlans.com Y0066_SB_H6528_031_000_2023_M H6528 031, H5322-031-000: UnitedHealthcare Dual Complete LP: Oklahoma: H5322-033-000: UnitedHealthcare Dual Complete Select: Oklahoma: H8125-003-000: UnitedHealthcare Dual Complete LP: Oklahoma: H8768-008-000: AARP® Medicare Advantage Choice Plan 1: Oklahoma: H8768-009-000: AARP® Medicare Advantage Choice: Oklahoma: H8768-016-000: AARP® Medicare ... , AARP Medicare Advantage Choice (PPO) Location: Sebastian, Arkansas Click to see other locations. Plan ID: H6528 - 031 - 0 Click to see other plans. Member Services: 1-800 …, National Center 7272 Greenville Ave. Dallas, TX 75231 Customer Service 1-800-AHA-USA-1 1-800-242-8721 Contact Us Hours Monday - Friday: 7 a.m. – 7 p.m. CT Saturday: 9 a.m. - 5 p.m...., 3.5 out of 5 stars* for plan year 2023. UnitedHealthcare Chronic Complete (PPO C-SNP) is a PPO C-SNP Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H6528-038-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., State Well Codes. The State Well Codes database stores state standards for the construction of private water wells. Included in the database is state-specific information on various codes related to well construction and siting. To find information on your state or other states, use the searchable database below., Cisco Systems (NASDAQ:CSCO), the global leader in networking technologies, is offering great value at its current price levels. Increasing comp... Cisco Systems (NASDAQ:CSCO), the ..., Jan 1, 2023 · H6528-033-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m.-8 p.m. local time, 7 days a week AARPMedicarePlans.com Y0066_SB_H6528_033_000_2023_M , Indices Commodities Currencies Stocks, AARP Medicare Advantage Choice (PPO) is a PPO plan offered by UnitedHealthcare that covers prescription drugs, vision, dental, hearing, and other services. The plan has a monthly premium of $0.00, a deductible of $0.00, and a maximum out-of-pocket maximum of $5,700.00., From flying high above the mountains, to paddling through North America's deepest river gorge. There’s a famous saying in the ski community of Sun Valley that goes, “The higher you..., 4 out of 5 stars* for plan year 2024. AARP Medicare Advantage from UHC FL-0027 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H2406-019-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., 2022 Medicare Advantage Plan Details. Medicare Plan Name: AARP Medicare Advantage Choice (PPO) Location: Lawrence, Alabama 35650 Click to see other locations. Plan ID: H6528 - 033 - 0 Click to see other plans. Member Services: 1-800-643-4845 TTY users 711., Available online provider directories (PDF): CALIFORNIA 州 ALAMEDA 縣 Aetna Medicare Select Plan (HMO)_H0523-068. CALIFORNIA 州 SAN FRANCISCO 市 Aetna Medicare Select Plan (HMO)_H0523-070. CALIFORNIA 州 ALAMEDA 縣 SAN FRANCISCO 市 Aetna Medicare Value Plus Plan (HMO-POS)_H0523-076., AARP endorses the AARP Medicare Supplement Insurance Plans insured by UnitedHealthcare Insurance Company, 185 Asylum Street, Hartford, CT 06103. Policy form No. GRP 79171 GPS-1 (G-36000-4). Plan A may be available to persons under age 65 who are eligible for Medicare by reason of disability or End-Stage Renal Disease., Get 2022 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLC, Medicare Advantage plan with prescription drugs. Summary of benefits 2022. AARP® Medicare Advantage Choice (PPO) H6528-031-000. Look inside to take advantage of …, Enrolling in H6528-036-000 Medicare Advantage Plans in Wyoming Medicare beneficiaries from Wyoming may have access to Medicare Advantage plans from AARP and other insurance companies. Get help comparing your local plan options by calling to speak with a licensed insurance agent who can help you find out if your doctor and prescription drugs …, 2021 Medicare Advantage Plan Benefits explained in plain text. Plain text explanation available for any plan in any state. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, Inc, Specialist visit. $50 copay/visit. 40% coinsurance. Preauthorization is required. If you don't get preauthorization, benefits could be reduced by 50% of the total cost of the service. If you visit a health care. provider’s office or clinic. Preventive care/screening/. immunization., UnitedHealthcare® today introduced its 2024 Medicare Advantage plans, delivering a simpler member experience with enhanced benefits, broad network access and cost-savings through valuable specialty and prescription drug coverage., Friday the 13th has inspired tattoo shops in cities like Chicago to offering $13 Friday the 13th tattoo specials on Friday, October 13. By clicking "TRY IT", I agree to receive new..., H6528-033-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m.-8 p.m. local time, 7 days a week AARPMedicarePlans.com Y0066_SB_H6528_033_000_2023_M, H6528-006-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. Toll-free 1-844-723-6473, TTY 711 8 a.m. - 8 p.m. local time, 7 days a week www.UHCMedicareSolutions.com Y0066_SB_H6528_006_000_2022_M, H6528 - 035 - 0 Click to see other plans: Member Services: 1-800-643-4845 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options., Jan 1, 2023 · h6528-038-000 Look inside to take advantage of the health services and drug coverages the plan provides. Call Customer Service or go online for more information about the plan. , Medicare Contact Information: 1-800-MEDICARE (1-800-633-4227) TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the AARP Medicare Advantage Choice (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 (see Plan Premium Details below) Annual Deductible:, Friday the 13th has inspired tattoo shops in cities like Chicago to offering $13 Friday the 13th tattoo specials on Friday, October 13. By clicking "TRY IT", I agree to receive new..., 3.5 out of 5 stars* for plan year 2023. AARP Medicare Advantage Choice Plan 2 (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by UnitedHealthcare. Plan ID: H6528-035-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $35.00 Monthly Premium., H6528 - 036 - 0 (3.5 / 5) AARP Medicare Advantage Choice Plan 1 (PPO) is a Medicare Advantage (Part C) Plan by UnitedHealthcare. Premium: $0.00 Enroll Now This page features plan details for 2023 AARP Medicare Advantage Choice Plan 1 (PPO) H6528 – 036 – 0 available in Select Counties in Wyoming., This Medicare Advantage Plan with Prescription Drug Coverage is a Local PPO plan. Plan Membership and Plan Ratings. The AARP Medicare Advantage Choice (PPO) (H6528 - …, AARP Medicare Advantage Choice (PPO) is a PPO plan offered by UnitedHealthcare that covers prescription drugs, vision, dental, hearing, and other services. The plan has a monthly premium of $0.00, a deductible of $0.00, and a maximum out-of-pocket maximum of $5,700.00. , Plan ID: H6528-035-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $35.00 Monthly Premium , In-Network: Doctor Specialty Visit: Copayment for Physician Specialist Office Visit $40.00. Prior Authorization Required for Doctor Specialty Visit. Inpatient hospital care. In-Network: Acute Hospital Services: $295.00 per day for days 1 to 7. $0.00 per day for days 8 to 90.