We are pleased to announce
that for 2013, AmeriHealth is introducing AmeriHealth 65 Preferred HMO, an
enhanced, affordably priced Medicare Advantage HMO plan. Members receive all
the benefits of Original Medicare, plus many more when they use providers in
the AmeriHealth New Jersey provider network. The plan is available to the
Medicare-eligible population residing in Burlington, Camden, Cumberland,
Gloucester, and Salem Counties. The premium for AmeriHealth 65 Preferred HMO is
$24.30 for the medical-only plan, and $74.90 for the medical and prescription
drug plan. The plan has a $6,700 out-of-pocket maximum for 2013.
AmeriHealth 65 Preferred is an
alternative to the AmeriHealth 65 NJ HMO plan, which will be discontinued for
individuals only, beginning January 1, 2013. In addition to comprehensive
medical coverage and vision, dental, and hearing services, AmeriHealth 65
Preferred features an extensive provider network with more than 3,000 primary
care physicians, 50,000 specialist sites, and 100 hospitals, including
Philadelphia-area providers.
Members receive access to the
SilverSneakers? Fitness Program; preventive
care; health resources and wellness programs; and support for managing chronic
conditions, such as asthma, diabetes, and chronic obstructive pulmonary disease
(COPD).
Medicare Part D prescription drug
coverage is optional.
AmeriHealth 65 Preferred HMO benefit
highlights
|
|
Primary care physician (PCP)
visits
|
$15 copay per visit
|
Specialist visits
|
$35 copay per visit
|
Emergency department
|
$65 copay per visit (not waived if
admitted)
|
Urgent care
|
$15 or $35 copay per visit
|
Outpatient surgery
|
$350 copay (per date of service)
for Hospital; $100 copay for Ambulatory Surgical Centers (per date of
service)
|
Inpatient hospital
|
$245 per day for days 1-7 ($1,715
per stay maximum); unlimited days each benefit period
|
Fitness program
|
SilverSneakers?
|
Preventive dental
|
$10 every six months exams and
cleanings
|
Eyewear
|
$100 every 2 years ($65 frames, $35
lenses); $40 copay for eye exam every 2 years
|
Hearing aids and exams
|
Up to $500 for hearing aids (two
aids) every 3 years; routine hearing exam ($40 every 3 years)
|
Please contact your Network Coordinator
or Hospital/Ancillary Services Coordinator if you have any questions.
SilverSneakers® is a registered
mark of Healthways, Inc.