H3447 011 01

Routine hearing services:1. This plan covers 1 routine hearing exam(s) and hearing aid fitting/evaluation(s) every year. $3,000.00 maximum plan benefit for hearing aids every year. Doctors in our plan: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount.

H3447 011 01. Anthem Extra Help (HMO) Benefits included: Dental X-rays: include one full-mouth or panoramic X-ray and one set/ series of bitewing X-rays each year and up to seven periapical images per calendar year. Two fluoride treatments You pay 20% of the covered charges for certain restorative dental services (fillings).

2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Star Rating Details

The table below outlines some of the specific plan details for Anthem HealthKeepers Medicare Advantage prescription drug plans available in Virginia in 2024. Plan Name. Plan Code. Monthly Premium. Deductible. Out of. Pocket …Anthem MediBlue Plus (HMO) is a Medicare Advantage (Part C) Plan by Anthem HealthKeepers. This page features plan details for 2023 Anthem MediBlue Plus (HMO) H3447 – 038 – 1 available in Surrounding St. Louis Counties. IMPORTANT: This page features the 2023 version of this plan. See the 2024 version using the link below:Number of Members enrolled in this plan in (H3447 - 022): 6,677 members : Plan's Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: 4 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 3 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits DetailsAnthem MediBlue Plus (HMO) is a Medicare Advantage (Part C) Plan by Anthem HealthKeepers. This page features plan details for 2022 Anthem MediBlue Plus (HMO) H3447 - 036 - 1 available in Select counties in Indiana. IMPORTANT: This page features the 2022 version of this plan. See the 2024 version using the link below:

H3447_011-000_045-000_VA_HMO D-SNP Medicare Advantage and Part D Plan year: January 1 – December 31, 2024 Virginia Central, NOVA, Southwest, Tidewater Regions, other Virginia counties. Full service area on page 2, Summary of Benefits. Anthem Full Dual Advantage 2 (HMO D-SNP) Anthem Full Dual Advantage (HMO D-SNP) of …Plan ID: H3447-011-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Virginia Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. ...Medicare Advantage plans can help you save money. With low or no monthly premiums, copays, or deductibles, our Anthem Medicare Advantage HMO plans, formerly MediBlue, can help you keep to your budget without sacrificing coverage. Monthly premiums as low as $0. You will still have to pay your Medicare Part B premium. Copays as low as $0.2024 Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011- in VA Plan Benefits DetailsH3447_013-000_VA_HMO Medicare Advantage and Part D Plan year: January 1 - December 31, 2024 Virginia Tidewater Region, other Virginia counties. Full service area on page 2, Summary of Benefits. Anthem Medicare Advantage (HMO) of Benefits 3447013 O_2The M30-011-30 is the industrial-grade Gigabit PoE+ Media Converter, featuring one 100/1000BASE-X SFP fiber port and one 10/100/1000BASE-T 802.3at PoE+ copper port in an IP30-rated rugged but compact-size case. Being able to operate under the temperature ranging from -40 to 75 degrees C, the M30-011-30 provides reliable, stable and …Anthem Full Dual Advantage 2 H3447-011 (HMO D-SNP) Virginia. Medicare. Health. Anthem Full Dual Advantage 2 (HMO D-SNP) H3447-011. Anthem HealthKeepers | Local HMO. Why Trust U.S. News. 344.The Anthem MediBlue Full Dual Advantage (HMO D-SNP) (H3447 - 011) currently has 22,359 members. There are 35 members enrolled in this plan in Galax City, Virginia, and 22,241 members in Virginia. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 4 stars.

Durable medical equipment (DME) In-Network: Your cost is $0.00 copay when the value of the DME is $499.99 or less. Your cost is 20% coinsurance when the value of the DME is $500.00 or more. Diagnostic tests, lab and radiology services, and X-rays. In-Network: Lab Services: $0.00 copay. X-Rays: $0.00 copay.Number of Members enrolled in this plan in (H3447 - 024): 5,751 members : Plan’s Summary Star Rating: 3.5 out of 5 Stars. • Customer Service Rating: 4 out of 5 Stars. • Member Experience Rating: 4 out of 5 Stars. • Drug Cost Accuracy Rating: 3 out of 5 Stars. — Plan Premium Details — The Monthly Premium is Split as Follows: : Total ...Anthem Dual Advantage (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield. Plan ID: H3447-047-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $26.90 Monthly Premium.While Medicare Advantage plan availability, costs and benefits can vary from one area to another, the average premium for a Medicare Advantage plan with drug coverage in 2024 is $14.14 per month. There are 3,959 Medicare Advantage plans nationwide in 2024, which means the average Medicare beneficiary has access to 43 different Medicare ...Herbier Face Youth Balm With Sage Essential Oil 内容量50ml/1.6oz 広告文責The Fresh Group Limited 03-6674-7335 メーカー(製造)・輸入者名Payot パイヨ ・個人 ...2024 Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011- in VA Plan Benefits Details

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2024 Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011- in VA Plan Benefits Details2019 Anthem MediBlue Dual Advantage (HMO SNP) in VA - H3447-011- in VA Plan Benefits Details2022 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Star Rating DetailsH3447_011-000_045-000_VA_HMO D-SNP Medicare Advantage and Part D Plan year: January 1 - December 31, 2024 Virginia Central, NOVA, Southwest, Tidewater Regions, other Virginia counties. Full service area on page 2, Summary of Benefits. Anthem Full Dual Advantage 2 (HMO D-SNP) Anthem Full Dual Advantage (HMO D-SNP)

2022 Anthem HealthKeepers (H3447) Star Rating Details; Anthem MediBlue Essential (HMO) (H3447-025-0) Benefit Details The Anthem MediBlue Essential (HMO) (H3447-025-0) in Franklin, VA: CMS MA Region 7 which includes: VA: Star Rating Category & Measures: 2022: 2021: Overall Star Rating: 3.5: 3.5: Summary Rating of Prescription Drug Plan Quality: 4Get 2020 Medicare Advantage Part C/Part D Health and Prescription plan benefit details for any plan in any state, including premiums, deductibles, Rx cost-sharing and health benefits/cost-sharing. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1Group LLCFifty centiliters is equal to 0.5 liters, also known as a half liter. This is because 100 centiliters make up 1 liter, or to put it differently, 1 centiliter is equal to 0.01 liter...Cost. Hearing Benefits. In-Network: Medicare Covered Hearing Exam: $0.00 copay. Routine Hearing Exam: $0.00 copay for routine hearing exam (s). $0.00 copay for hearing aids up to the maximum plan benefit amount. This plan covers 1 routine hearing exam every year. $300.00 maximum plan benefit for over-the-counter hearing aids OR 1 routine ...2021 Medicare Advantage Plan Benefits explained in plain text. Plain text explanation available for any plan in any state. Sign-up for our free Medicare Part D Newsletter, Use the Online Calculators, FAQs or contact us through our Helpdesk -- Powered by Q1GROUP LLC and National Insurance Markets, IncH3447-011-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO. ... H3447-010-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO.H3447 - 014 - 0 Click to see other plans: Member Services: 1-844-395-1019 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) in VA - H3447-011- in VA Plan Benefits DetailsH3447-011: Anthem MediBlue Dual Advantage (HMO D-SNP) 2024: H3447-030: Anthem Kidney Care (HMO C-SNP) 2024: H3447-033: Anthem Full Dual Advantage Support (HMO D-SNP) 2024: H3447-044: Anthem Full Dual Advantage (HMO D-SNP) 2024: H3447-045: Cigna View payer . Plan Name Effective Year Benefit Package;

2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Details

Emergency Care: $120.00 copay. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000.00 per year. Ambulance transportation. Ground Ambulance: $295.00 copay Per Trip.Anthem PPO plans are Medicare Advantage plans that offer the benefits of a Preferred Provider Organization (PPO) plan, including flexibility to choose doctors in and out of the plan network. These plans were previously known as MediBlue, we still offer the same great PPO plans with a new name as Anthem Medicare Advantage PPO plans.2020 Anthem MediBlue Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits ExplainedH3447_014-000_VA_HMO Anthem MediBlue Plus (HMO) Anthem MediBlue Plus (HMO) Anthem MediBlue Plus (HMO) Our service area includes these counties in VA: Alexandria City, Arlington, Fairfax, Fairfax City, Loudoun, Manassas Park City, Prince William Do you have questions?Days 1-6: $285.00 per day, per admission / Days 7-90: $0.00 per day, per admission. Additional Hospital Days: Unlimited additional days. Urgent care. Urgent Care: $50.00 copay. Emergency room visit. Emergency Care: $90.00 copay. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United …H3447-028-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO. ... H3447-011-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO.2021 Medicare Advantage Plan Details. Medicare Plan Name: Anthem MediBlue Dual Advantage (HMO D-SNP) Location: Orange, Indiana Click to see other locations. Plan ID: H3447 - 020 - 0 Click to see other plans. Member Services: 1-844-533-2021 TTY users 711.

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2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits DetailsSep 25, 2023 · Anthem Extra Help (HMO) Benefits included: Dental X-rays: include one full-mouth or panoramic X-ray and one set/ series of bitewing X-rays each year and up to seven periapical images per calendar year. Two fluoride treatments You pay 20% of the covered charges for certain restorative dental services (fillings).2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits DetailsAnthem Full Dual Advantage Aligned (HMO D-SNP) Location: Dubois, Indiana Click to see other locations. Plan ID: H3447 - 048 - 0 Click to see other plans. Member Services: 1-844-395-1019 TTY users 711. Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.In-Network: Days 1-6: $285.00 per day, per admission / Days 7-90: $0.00 per day, per admission. Additional Hospital Days: Unlimited additional days. Urgent care. Urgent Care: $25.00 copay. Emergency room visit. Emergency Care: $90.00 copay. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the ...Current members please call 1-844-533-2021 (toll-free) or 711 (TTY). This plan is available to anyone who has both Medical Assistance from the State and Medicare. Anthem Blue Cross and Blue Shield is an HMO D-SNP plan with a Medicare contract and a contract with the Indiana Medicaid program.3.5 out of 5 stars* for plan year 2024. Anthem Dual Advantage (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield. Plan ID: H3447-046-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $29.50 Monthly Premium.The Anthem Full Dual Advantage 2 (HMO D-SNP) offers prescription drug coverage, with an annual drug deductible of $545.00. When reviewing Virginia Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the ...H3447_013-000_VA_HMO Medicare Advantage and Part D Plan year: January 1 - December 31, 2024 Virginia Tidewater Region, other Virginia counties. Full service area on page 2, Summary of Benefits. Anthem Medicare Advantage (HMO) of Benefits 3447013 O_2H3447 - 027 - 0 Click to see other plans: Member Services: 1-844-395-1019 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine Nadia Hansel, MD, MPH, is the interim director of the Department of Medicine in th... ….

Emergency Care: $120.00 copay. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000.00 per year. Ambulance transportation. Ground Ambulance: $295.00 copay Per Trip.TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Medicare Plus Blue PPO Signature (PPO) benefit details. — Medicare Plan Features —. Monthly Premium: $150.00. Annual Deductible: $0. Annual Initial Coverage Limit (ICL):2021 Medicare Advantage Plan Details. Medicare Plan Name: Anthem MediBlue Dual Advantage (HMO D-SNP) Location: Orange, Indiana Click to see other locations. Plan ID: H3447 - 020 - 0 Click to see other plans. Member Services: 1-844-533-2021 TTY users 711.The Anthem MediBlue Full Dual Advantage (HMO D-SNP) (H3447 - 011) currently has 21,684 members. There are 53 members enrolled in this plan in Amelia, Virginia, and 21,510 members in Virginia. The Centers for Medicare and Medicaid Services (CMS) has given this plan carrier a summary rating of 3.5 stars.2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Details2024 Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011- in VA Plan Benefits Details2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits ExplainedHealth Content Provider06/01/2025 A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify t...TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Anthem MediBlue Extra (HMO) benefit details. — Medicare Plan Features —. Monthly Premium: $25.80 (see Plan Premium Details below) Annual Deductible: $480 (Tier 1 and 6 excluded from the Deductible.) Annual Initial Coverage Limit (ICL):Routine hearing services:1. This plan covers 1 routine hearing exam(s) and hearing aid fitting/evaluation(s) every year. $3,000.00 maximum plan benefit for hearing aids every year. Doctors in our plan: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount. H3447 011 01, Medicare Plan Name: Anthem MediBlue Dual Advantage (HMO SNP) Location: Campbell, Virginia Click to see other locations. Plan ID: H3447 - 011 - 0 Click to see other plans. …, H3447 - 024 - 0. (3.5 / 5) Anthem Extra Help (HMO) is a Medicare Advantage (Part C) Plan by Anthem HealthKeepers. Premium: $16.70. Enroll Now. This page features plan details for 2024 Anthem Extra Help (HMO) H3447 - 024 - 0 available in Indiana. IMPORTANT: This page has been updated with plan and premium data for 2024., View the coverage and benefits provided in the Wellcare No Premium (HMO) plan from Wellcare by Allwell. Alight Retiree Health Solutions represents Medicare plans from 61 insurers nationwide., Plan Type. Local HMO. Monthly Plan Premium. $0.00. Health Plan Deductible. $0.00. Prescription Drug Plan Deductible. $545.00. Monthly Drug Premium *Included in Monthly Plan Premium., 2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Details, 2024 Anthem Full Dual Advantage 2 (HMO D-SNP) - H3447-011- in VA Plan Benefits Details, 2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Details, Plan ID: H3447:013-0. Basic Medical Costs and Coverage. Plan Deductible: $0. Out of Network Information: N/A. Out of Pocket Max: $3900. Primary Doctor Visit: In-Network: ... Last Update 10/01/2023. Our carrier partners do not discriminate, exclude people or treat them differently on the basis of race, color, national origin, sex, age or ..., H3447 - 030 - 0 (4 / 5) Anthem MediBlue Dual Advantage (HMO D-SNP) is a Medicare Advantage (Part C) Special Needs Plan by Anthem HealthKeepers. Premium: $0.00 Enroll Now This page features plan details for 2023 Anthem MediBlue Dual Advantage (HMO D-SNP) H3447 - 030 - 0 available in Select Counties in Virginia., Mental health services. Inpatient hospital - psychiatric. $300 per day for days 1 through 5 / $0 per day for days 6 through 90. Outpatient group therapy visit with a psychiatrist. $40 copay ..., TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Anthem MediBlue Dual Advantage (HMO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who qualify for both ..., TTY users 1-877-486-2048. or contact your local SHIP for assistance. Email a copy of the Anthem MediBlue Dual Advantage (HMO D-SNP) benefit details. — Medicare Plan Features —. Monthly Premium: $0.00 for people who qualify for both Medicare and Medicaid. (see Plan Premium Details below) Annual Deductible: $0 for people who …, Summary of benefits 2022 Medicare Advantage plan with prescription drugs UnitedHealthcare Dual Complete® (HMO D-SNP) H7464-001-000 Look inside to take advantage of the health services and drug coverages the plan provides., H3447_018-000_MO_HMO D-SNP Medicare Advantage and Part D Plan year: January 1 – December 31, 2024 Missouri St Louis, St Louis City, St Charles, Greene, other Missouri counties. Full service area on page 2, Summary of Benefits. Anthem Full Dual Advantage (HMO D-SNP) of Benefits 24MOH3447018 SNP_2, H1607-824. Anthem Senior Advantage (HMO) 2024. H3655-801. Anthem Senior Advantage (HMO) 2024. H3655-803. Discover Anthem Medicare Insurance Plans accepted at Oak Street Health centers and find primary care doctors accepting Anthem near you., H3447 - 037 - 0 Click to see other plans: Member Services: 1-844-469-1763 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options., Exhaust System #1. Exhaust System #2. Flywheel, Starter Kit, Rotating Screens. Fuel Supply. Lubrication. Replacement Engine. Rewind Starter. Shrouds, Air Guides. Repair parts and diagrams for 303447-0447-01 - Briggs & Stratton Horizontal Engine., 2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Details, Routine hearing services:1. This plan covers 1 routine hearing exam(s) and hearing aid fitting/evaluation(s) every year. $3,000.00 maximum plan benefit for hearing aids every year. Doctors in our plan: $0.00 copay for routine hearing exam(s). $0.00 copay for hearing aids up to the maximum plan benefit amount., H3447-028-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO. ... H3447-011-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO., H3447-011-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO. ... H3447-010-000. 2024 Overall Rating. 3.5 out of 5 stars. Anthem HealthKeepers | Local HMO., The Anthem Full Dual Advantage 2 (HMO D-SNP) offers prescription drug coverage, with an annual drug deductible of $545.00. When reviewing Virginia Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the ..., Anthem MediBlue Plus (HMO) is a Medicare Advantage (Part C) Plan by Anthem HealthKeepers. This page features plan details for 2022 Anthem MediBlue Plus (HMO) H3447 - 022 - 0 available in Select Counties in Indiana. IMPORTANT: This page features the 2022 version of this plan. See the 2024 version using the link below:, 2021 Anthem MediBlue Full Dual Advantage (HMO D-SNP) - H3447-011- in VA Plan Benefits Explained, H3447 - 025 - 0 (3.5 / 5) Anthem Medicare Advantage 2 (HMO) is a Medicare Advantage (Part C) Plan by Anthem HealthKeepers. Premium: $0.00 Enroll Now This page features plan details for 2024 Anthem Medicare Advantage 2 (HMO) H3447 - 025 - 0 available in Select Counties in Virginia., Anthem Full Dual Advantage (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield. Plan ID: H3447-020-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., 2020 Anthem MediBlue Dual Advantage (HMO D-SNP) - H3447-011- in VA Star Rating Details, Anthem Medicare Advantage (HMO) Location: Middlesex, Virginia Click to see other locations. Plan ID: H3447 - 013 - 0 Click to see other plans. Member Services: 1-844-395-1019 TTY users 711. Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options., Anthem Full Dual Advantage (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Anthem Blue Cross and Blue Shield. Plan ID: H3447-020-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium., View the coverage and benefits provided in the Wellcare No Premium (HMO) plan from Wellcare by Allwell. Alight Retiree Health Solutions represents Medicare plans from 61 insurers nationwide., Routine Hearing Exam: $0.00 copay for routine hearing exam (s). $0.00 copay for hearing aids up to the maximum plan benefit amount. This plan covers 1 routine hearing exam every year. $300.00 maximum plan benefit for over-the-counter hearing aids OR 1 routine hearing aid fitting evaluation and a $3,000.00 maximum plan benefit for prescribed ..., In-Network: Days 1-5: $325.00 per day, per admission / Days 6-90: $0.00 per day, per admission. Additional Hospital Days: Unlimited additional days. Urgent care. Urgent Care: $50.00 copay. Emergency room visit. Emergency Care: $90.00 copay. Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside …, H3447 - 025 - 0 Click to see other plans: Member Services: 1-844-395-1019 TTY users 711 — This plan information is for research purposes only. — Click here to see plans for the current plan year: Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.