Extra Plan (HMO) 010 - Community Health Plan of Washington - Medicare Advantage

Extra Plan (HMO) 010

The Extra Plan offers full coverage including prescription drugs, plus extra benefits. If you regularly take one or more prescription medications or have certain conditions with higher cost drug treatment, this plan may be for you. Extra coverage on the extra plan. Click the button below to learn how to enroll in this plan.

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2020 Plan Benefits at a Glance

Coverage in This Plan Includes:

Medical, Vision, Dental, Prescription Drug coverage, and more.

CHPW Medicare Advantage Original Medicare
Premium $32* Part B Premium
Pharmacy Tier 5 Preferred Pharmacy, 33% coinsurance Not Covered
Vision $0 copay, limit one exam per year. Up to $150 every two years for prescription eyewear Not Covered
Dental $0 copay, no limit for preventive dental services Not Covered
Podiatry $0 copay (up to 4 supplemental routine visits per year) Not Covered
Alternative Medicine $0 copay (up to 12 visits per year) for acupuncture, naturopathy, and non-Medicare covered chiropractic Not Covered
Fitness Program Free basic gym membership or Fitbit device, personal coaching Not Covered

*You must continue to pay your Medicare Part B premium.

The Summary of Benefits booklet gives you an idea of what services we cover and how much you pay. It does not list every service that we cover or list every limitation or exclusion.

➔ Summary of Benefits | Resumen de Beneficios

Offered in the Following Counties:

Adams, Benton, Chelan, Clark, Cowlitz, Douglas, Grant, Franklin, King, Kitsap, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, and Yakima.

Covered Services & Cost

The Evidence of Coverage lays out coverage and payment details for different services including copays, coinsurance, limitation, prior authorizations, and deductibles.

➔ Click to download Evidence of Coverage

Prescription Coverage

Browse the prescription drug formularies to check if your current medications are covered by the plan. Find information about restrictions and limitations to certain medications, and how much you will pay.  Download a PDF or search for your medications by name in the online formulary.

➔ Check prescription coverage

What has changed for 2020?

That’s a great question. Any changes to the plan are detailed in the Annual Notice of Change (ANOC).

➔ Download the 2020 Annual Notice of Change

Special Benefits

Fitness Program

Stay fit at home or at the gym with the Silver & Fit Program. Meet new people, participate in challenges, and earn rewards while you get exercise to keep you active and healthy.

➔ Explore our Fitness benefit

Post Discharge Meals

After an inpatient hospital or skilled nursing facility stay, members can receive 2 meals per day delivered to their door for 14 days.

➔ Learn more about Meals Benefits

DID YOU KNOW...?

Keep an Eye on Your Health

Woman getting an eye examRegular eye exams are important, even if you have good vision. Doctors can detect a variety of health issues just by examining your eye. Catching problems like tumors, diabetes or high blood pressure can help you get treatment before more serious symptoms show up.

Eye exams are covered in-network for CHPW Medicare Advantage members. Vision coverage is included in all plans.

LEARN MORE ABOUT THIS BENEFIT

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