The Benefit Comparison Chart below provides an overview of the most commonly used benefits and the coverage and cost differences between our Medicare Advantage plans. Use this to help find the plan that offers the benefits that are most important to you.
Benefits Comparison Chart*
*Covered services must be provided by a PSHP network provider or pharmacy for benefits to apply.
| Perscription Drugs |
| |
Partners Sound Plus Rx4
| Partners Charter Plus Rx |
Partners Apex Plus Rx |
Partners Summit Plus Rx
|
|
|
|
Deductible1 |
$295 |
$295
Tier I - $5 copay for Preferred Generics
|
$0
Tier I - Preferred Generics $5
Tier II - Preferred Brand $25
Tier III - Non-Preferred Brand $50
Tier IV - Speciality Drugs 25% Coinsurance |
$0
Tier I - Preferred Generics $5
Tier II - Preferred Brand $25
Tier III - Non-Preferred Brand $50
Tier IV - Speciality Drugs 25% Coinsurance
|
|
Initial Coverage Limit
|
Tier I - Preferred Generics $6
Tier II - Preferred Brand $25
Tier III - Specialty Drugs 25% Coinsurance
Tier IV Non-Preferred Brand $50 |
Tier I - Preferred Generics $5
Tier II - Preferred Brand $25
Tier III - Non-Preferred Brand $50
Tier IV Speciality Drugs 25% Coinsurance |
Tier I - Preferred Generics $5
Tier II - Preferred Brand $25
Tier III - Non-Preferred Brand $50
Tier IV Speciality Drugs 25% Coinsurance |
Tier I - Preferred Generics $5
Tier II - Preferred Brand $25
Tier III - Non-Preferred Brand $50
Tier IV Speciality Drugs 25% Coinsurance
|
|
Coverage Gap
|
$2,700 - $4,350 |
$3,200 - 4,350
|
$2,700 - $4,350 |
$2,700 - $4,350
|
|
Catastrophic Coverage
|
Tier I - Greater of $2.40
Tier II - $6.00 or 5% Coinsurance |
Tier I - Greater of $2.40
Tier II - $6.00 or 5% Coinsurance |
Tier I - Greater of $2.40
Tier II - $6.00 or 5% Coinsurance |
Tier I - Greater of $2.40
Tier II - $6.00 or 5% Coinsurance |
1 Amount shown does not include Medicare Part B premium. Beneficiaries who qualify for extra financial help will generally pay a lower monthly plan premium. For more information, visit www.medicare.gov on the web, or call 1-800-MEDICARE (633-4227) for more information. TTY/TDD for the hearing-impaired, call 1-877-486-2048.
2 Applies to Medicare-covered hospital stays. A $0 co-payment for additional hospital days. Limits may apply. See the Summary of Benefits in your information packet, or call Member Services at 1-866-789-PSHP (7747) 8 a.m. – 8 p.m., 7 days a week. TTY/TDD for the hearing-impaired, call 1-866-264-4141.
3 This cost amount pertains to King County premiums.
4 This plan is not currently available in King County.
| For complete benefit details |
Our Summary of Benefits offers complete benefit details for each plan. Just click on the links below to review or download these helpful documents:
Partners Charter PlanTM
Partners Charter Plus RxTM
Partners ApexTM
Partners Apex PlusTM
Partners Sound PlusTM
Partners Summit PlusTM
Plan Summary of Benefits
Partners CharterTM Plan
Our Partners CharterTM
Plan
gives you all the coverage of original Medicare plus more for no monthly premium cost. It’s a good choice if you already have a stand-alone prescription drug plan through a creditable retiree program or military benefits and prefer not to have an additional monthly expense.
- $0 monthly premium
- Offers physician and hospital coverage
- Excludes coverage for Part D prescriptions
- $10 co-payment for each in-network Primary Care Physician (PCP) office visit
- $30 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners CharterTM
Plan and Partners Charter Plus RxTM
Plan Summary Of Benefits (pdf)
Partners CharterTM
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
Partners Charter PlusTM
Plan
Our Partners Charter Plus RxTM Plan offers all the benefits of original Medicare plus more—including Part D prescription coverage—for one low monthly premium payment. This plan is ideal if you need prescription coverage and want to keep your monthly premium costs to a minimum.
- $41 monthly premium
- Offers physician, hospital, and Part D prescription coverage
- Coverage for covered, generic medications through the deductible ($295 deductible applies for covered non-generic drugs)
- $10 co-payment for each in-network Primary Care Physician (PCP) office visit
- $30 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners CharterTM
Partners Charter Plus RxTM
Plan Summary Of Benefits (pdf)
Partners Charter Plus
TM
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
Partners ApexTM Plan
Medicare Advantage Plans that offer choice and value
Our Partners ApexTM
Plan gives you all the coverage of original Medicare plus more, with low co-payments for physician and hospital care. It’s a good choice if you require frequent medical care, want to save money on upfront out-of-pocket costs and already have a stand-alone prescription drug plan.
- $60 monthly premium ($63 in King County)
- Offers physician and hospital coverage
- Excludes coverage for Part D prescriptions
- $5 co-payment for each in-network Primary Care Physician (PCP) office visit
- $15 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners Apex
TM
Plan and Partners Apex Plus RxTM
Plan Summary Of Benefits (pdf)
Partners ApexTM
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
Partners Apex PlusTM Plan
Our Partners Apex Plus RxTM
Plan provides physician and hospital coverage that goes beyond traditional Medicare, with low co-payments and the advantage of Part D prescription drug coverage. This plan is a good choice if you want comprehensive medical and prescription coverage, with low upfront out-of-pocket costs.
- $127 monthly premium ($130 in King County)
- Offers physician, hospital, and Part D prescription coverage
- $0 deductible for all covered drugs
- $5 co-payment for each in-network Primary Care Physician (PCP) office visit
- $15 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners ApexTM
Plan and Partners Apex Plus RxTM
Plan Summary Of Benefits (pdf)
Partners Apex Plus RxTM
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
Partners Sound PlusTM Plan
Our Partners Sound Plus RxTM
Plan offers all the benefits of original Medicare plus more—including Part D prescription coverage—for no monthly premium payment. This plan is ideal if you need prescription coverage, while keeping costs to a minimum, with low co-payments. This plan is a complete and unique choice if you want comprehensive medical and prescription coverage.
- $0 monthly premium
- Offers physician, hospital, and Part D prescription coverage
- $Coverage for covered, generic medications through the deductible ($295 deductible applies for covered non-generic drugs)
- $15 co-payment for each in-network Primary Care Physician (PCP) office visit
- $40 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners SoundTM
Partners Sound Plus RxTM
Plan Summary Of Benefits (pdf)
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
Partners Summit PlusTM Plan
Our Partners Summit Plus RxTM
Plan provides physician and hospital coverage, with low co-payments and the advantage of Part D prescription drug coverage. This plan is an excellent choice for both comprehensive medical and prescription coverage, with low out-of-pocket costs.
- $169 monthly premium
- Offers physician, hospital, and Part D prescription coverage
- $0 deductible for all covered drugs
- $0 co-payment for each in-network Primary Care Physician (PCP) office visit
- $15 co-payment for each PCP-referred in-network specialist office visit
- No co-payments for annual preventive services such as mammograms and colorectal screenings
Partners SummitTM
Plan Summary Of Benefits (pdf)
Summit Plus RxTM
Plan Evidence of Coverage (pdf)
Download Printable Enrollment Application
PSHP Value Added Benefits
More benefits for you. The most valued partner.
Each of our plans provide you with all of the coverage of original Medicare and more, including additional benefits such as:
- Routine Vision Exams
- Routine Hearing Exams
- Chiropractic & Acupuncture
- Individual Assistance Program
* For more information about these benefits please contact Member Services at 1-866-789-PSHP (7747).