The Medicare Advantage Plan 1 is our best value plan, offering prescription drug, vision, and dental coverage, plus the protection of an out-of-pocket maximum. All for a $0 monthly premium*.
- New $0 copay for primary care visits
- Hundreds of dollars in preventive and comprehensive dental coverage
If you are generally healthy, this plan may be for you. Available in most counties.
Plan Benefits at a Glance
Coverage Includes: Medical, Vision, Prescription Drugs, Fitness Program, and more.
Where This Plan is Offered: Clallum, Clark, Cowlitz, Jefferson, King, Kitsap, Pierce, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, and Yakima counties.
|CHPW Medicare Advantage||Original Medicare|
|Premium||$0*||Part B Premium|
|Pharmacy||5 Tiers (1/2/3/4/5)
$230 deductible on Tier 5 specialty drugs only
Use preferred pharmacy and preferred mail order for lowest copay
|Vision||$0 copay, limit one exam per year. Up to $150 every two years for prescription eyewear.||Not Covered|
|Dental||$0 copay. Up to $200 per year for
preventative and comprehensive services.
|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||Fitness kit and gym membership||Not Covered|
*You must continue to pay your Medicare Part B premium.
Covered Services & Cost
Evidence of Coverage
The Evidence of Coverage (EOC) provides plan details and payment information for services, including copays, coinsurance, limitation, prior authorizations, and deductibles.
Prescription drug formularies provide information about costs, restrictions, and other considerations related to the plan’s prescription medication coverage.
Providers and Care Facilities
Has Anything Changed for 2022?
Download the 2022 Annual Notice of Change (ANOC) to review any changes to the plan.