Medical Coverage Is Included on All Plans

Medical coverage on our plan includes the same benefits as Original Medicare Parts A and B (medical and hospital insurance.)

Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services.
Coverage on your Advantage Plan includes coverage for other areas of your health and may include alternative medicine, like acupuncture and naturopathy.

Medical Services:

  • Hospital and medical insurance (Medicare Part A & B)
  • Primary care
  • Specialist care
  • Lab services
  • Urgent care and emergency care
  • Ambulance services
  • Diabetic supplies
  • Podiatry
  • Chiropractic
  • Acupuncture*
  • Naturopathy*

Doctor Visits:

  • Primary and preventive care visits
  • Specialist appointments with an in-network provider
  • Urgent care visits
  • Physical therapy

Diagnostic Services:

  • Radiology
  • Tests and procedures outside of preventive tests
  • Lab services
  • Outpatient x-ray
  • Therapeutic radiology services (such as radiation treatment for cancer).

*Alternative medicine services are not covered on plan 009, 010, or 016.

Medical Benefits by Plan

MA Plan 006
Primary Care (per visit): $0 copay

Specialist Care (per visit) $40 copay

Medicare-covered Lab Services: $0 of the cost

Urgent Care (per visit): $0 copay

Emergency Care (per visit): $90 copay

Diabetic Supplies: $0 Copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: $20 copay per Medicare covered visit

Acupuncture and Naturopathy: $0 copay ($250 combined benefit limit every year)

Out-of-pocket Maximum: $6,700 per calendar year

MA Pharmacy Plan 008
Primary Care (per visit): $0 copay

Specialist Care (per visit) $40 copay

Medicare-covered Lab Services: $0 of the cost

Urgent Care (per visit): $0 copay

Emergency Care (per visit): $90 copay

Diabetic Supplies: $0 Copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: $20 copay per Medicare covered visit

Acupuncture and Naturopathy: $0 copay ($250 combined benefit limit every year)

Out-of-pocket Maximum: $6,700 per calendar year

MA Pharmacy Plan 009
Primary Care (per visit): $0 copay

Specialist Care (per visit) $40 copay

Medicare-covered Lab Services: $0 of the cost

Urgent Care (per visit): $0 copay

Emergency Care (per visit): $90 copay

Diabetic Supplies: $0 Copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: $20 copay per Medicare covered visit

Acupuncture and Naturopathy: not covered

Out-of-pocket Maximum: $6,700 per calendar year

MA Extra Plan 010
Primary Care (per visit): $10 copay

Specialist Care (per visit) $45 copay

Medicare-covered Lab Services: $0 of the cost

Urgent Care (per visit): $10 copay

Emergency Care (per visit): $90 copay

Diabetic Supplies: $0 Copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: 20% of the cost per Medicare covered visit

Acupuncture and Naturopathy: not covered

Out-of-pocket Maximum: $6,700 per calendar year

MA Special Needs Plan 014
Primary Care (per visit): $0 copay

Specialist Care (per visit) $0 copay

Medicare-covered Lab Services: $0 of the cost

Urgent Care (per visit): $0 copay

Emergency Care (per visit): $0 copay

Diabetic Supplies: $0 Copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: $0 copay per Medicare covered visit

Acupuncture and Naturopathy: $0 copay ($250 combined benefit limit every year)

Out-of-pocket Maximum: $6,700 per calendar year

MA Value Plan 016
Primary Care (per visit): $15 copay

Specialist Care (per visit): $50 copay

Medicare-covered Lab Services: 0% of the cost

Urgent Care (per visit): $15 copay

Emergency Care (per visit): $90 copay

Diabetic Supplies: $0 copay

Podiatry: $0 copay (up to four routine visits per year)

Chiropractic: 20% of the cost per Medicare covered visit

Acupuncture and Naturopathy: not covered

Out-of-pocket Maximum: $6,700 per calendar year

DID YOU KNOW...?

Get to Know HealthPoint

One of our community health center partners, HealthPoint has many locations across King County. Their approach to health care is to bring together all the services someone needs to be healthy, in one place. We support their model of whole person care and together, our goal is healthier people and a healthier community.

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We are now 
Community Health Plan of Washington
Medicare Advantage


With a new name comes new benefits.
Our  2020 Medicare Advantage plan details
will be available on October 1st, 2019.

 

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