MA Dual Plan (HMO D-SNP) - Community Health Plan of Washington - Medicare Advantage

MA Dual Plan (HMO D-SNP)

The Medicare Advantage Dual (HMO D-SNP) plan offers added support for individuals who qualify for both Medicare Parts A and B and Apple Health (Medicaid) benefits.

  • Up to $5,000 on preventive and comprehensive dental care
  • Monthly over-the-counter (OTC) and grocery benefit of up to $175
  • Up to $500 per year to spend on eyewear
  • 60 hours per year of free personalized support and companionship with Family on Demand
  • $0 copay for up to 25 combined sessions of acupuncture, naturopathy, routine chiropractic, massage therapy, and more!

Note: Your monthly plan premium may be paid for as long as you qualify for 100% Low Income Subsidy (“Extra Help”). Your Medicare Part B premium must continue to be paid, although that too may be paid for through these subsidies. Contact us to learn more: 1-800-942-0247 (TTY Relay: 711), 8 a.m. to 8 p.m., seven days a week.
ENROLL NOW

Plan Benefits at a Glance

Coverage Includes: Medical, Vision, Dental, Prescription Drugs, Over-the-Counter benefits, Hearing Aid Supplement, Transportation, Fitness Program, and more.

Download the Summary of BenefitsResumen de Beneficios (Spanish)

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

CHPW Medicare Advantage Original Medicare
Premium $0* $0
Pharmacy Generic drugs: $0 to $4.15
Brand drugs: $0 to $10.35
Not Covered
Vision 1 routine eye exam per year + up to $500 every year for prescription vision hardware Not Covered
Dental $0 copay. Up to $5,000 per year for
preventative and comprehensive services.
Not Covered
Hearing Aids $0 copay exam and fitting. Up to $2,250 for hearing aids and supplies every year. Not Covered
Podiatry $0 copay. Up to 4 supplemental routine visits per year. Not Covered
Health and Wellbeing $0 copay. Up to 25 visits combined per year for acupuncture, naturopathy, massage therapy, and non-Medicare covered chiropractic, as well as various CHPW-recommended Wellbeing programs Not Covered
Family on Demand 60 hours per year of free personalized support and companionship Not Covered
Transportation 75 one-way rides per year to provider offices, medical centers, and pharmacies Not Covered
Over the Counter Allowance (OTC) $125 to spend on health products each month Not Covered
Grocery $50 to spend on groceries each month, up to $600 per year Not Covered
Fitness Program Fitness kit and gym membership Not Covered

*Your monthly plan premium of $41 is paid for as long as you qualify for 100% Low Income Subsidy (“Extra Help”). For more information on Extra Help, see Chapter 2, section 7, of your Evidence of Coverage. Your Medicare Part B premium must continue to be paid, although that too may be paid for through these subsidies.

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

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 2023?

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

 

DID YOU KNOW...?

Dental Coverage

Keeping your teeth and gums healthy is an important part of your whole health care plan. Dental coverage is included on all plans for yearly cleanings, x-rays, and fluoride treatments. Select plans have additional coverage for other basic and major dental services.

LEARN MORE

☏ HAVE QUESTIONS ?

Sales Team

Get real answers
from real people

Phone: 1-800-944-1247
Email: [email protected]

x