MA Plan 2 (HMO)

The Medicare Advantage Plan 2 is similar to our best value plan, but with the added benefits of one free preventive dental visit every year and lower copays for services like specialist and hospital visits. All for a low monthly premium.

• New $0 copay for primary care visits
• Hundreds of dollars in preventive and comprehensive dental coverage
• The financial security of an out-of-pocket maximum

ENROLL NOW

Plan Benefits at a Glance

Coverage Includes: Medical, Vision, Dental, Prescription Drug coverage, and more.

➔ Download the Summary of Benefits – Plan 2 begins on page 24 | Resumen de Beneficios (Spanish) | 福利摘要 (Chinese) | Краткий обзор льгот (Russian) | Tóm Tắt Quyền Lợi (Vietnamese)

Where This Plan is Offered: Adams, Benton, Chelan, Clallam, Clark, Cowlitz, Douglas, Franklin, Grant, Jefferson, King, Kitsap, Pierce, Skagit, Snohomish, Spokane, Stevens, Thurston, Walla Walla, Whatcom, and Yakima counties.

	CHPW Medicare Advantage	Original Medicare
Premium	$40.50*	Part B Premium
Pharmacy	5 Tiers (1/2/3/4/5) Preferred: $0/$10/$42/50%/33% Standard: $5/$15/$47/50%/33% Use preferred pharmacy and preferred mail order for lowest copay	Not Covered
Vision	$0 copay, limit one exam per year. Up to $150 every two years for prescription eyewear.	Not Covered
Dental	$0 copay. One free preventive visit per year + up to $200 per year for preventative and comprehensive 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	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 Coverage

Prescription drug formularies provide information about costs, restrictions, and other considerations related to the plan’s prescription medication coverage.

Special Benefits

• Fitness Program
• Post-Discharge Meals

Providers and Care Facilities

Use our Find a Doctor tool or browse our provider directories to find primary care providers, vision providers, specialists, care facilities, and pharmacies in our network.

Has Anything Changed for 2022?

Download the Annual Notice of Change (ANOC) to review any changes to the plan.

• Annual Notice of Change (ANOC)
• Annual Notice of Change (ANOC) – Spanish