- Plan Overviews
- Benefit Plan Comparison - without Drug Coverage
- Benefit Plan Comparison - with Drug Coverage
- Featured Benefits
- Request FREE Information
- Value Added Benefits
- Optional Supplemental Benefits
- Enroll Now!
The Big Picture.
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.
Plans With Perscription Drug Coverage
| Partners Sound +Rx (HMO) |
Partners Charter +Rx (HMO) |
Partners Apex +Rx* (HMO) |
Partners Summit +Rx (HMO-POS) |
|
|---|---|---|---|---|
| Monthly Premium | $0 | $70 | $150/$160* | $180 |
| Maximum Out of Pocket Expense | $3,350 | $2,250 | $1,000 | $1,000 (In-network services only) |
| Annual Preventive Exam Copayment | $0 | $0 | $0 | $0 |
| Primary Care Copayment | $15 | $10 | $5 | $5 |
| Specialist Copayment | $40 | $30 | $15 | $15 |
| Inpatient Hospital Copayment | $250 per day | $200 per day days 1-5; $0 additional days | $100 per day, days 1-5; $0 additional days | $100 per day, days 1-5; $0 additional days |
| Emergency Care Copayment | $50 | $50 | $50 | $50 |
| Routine Vision Care | $40 for annual routine eye exam | $30 for annual routine eye exam; $100 hardware allowance every 2 years | $15 for annual routine eye exam; $100 hardware allowance every 2 years | $15 for annual routine eye exam; $100 hardware allowance every 2 years |
| Routine Transportation | None | 20 one-way trips $0 copay | 20 one-way trips $0 copay | 20 one-way trips $0 copay |
| Silver&Fit Program | Included | Included | Included | Included |
| Point of Service Benefits | None | None | None | $50 copayment for out-of-network physician visits |
Part D Prescription Drugs |
||||
| Deductible | $310 Preferred Generics $5 copayment |
$0 | $0 | $0 |
| Tier I - Preferred Generics copayment | $5 | $5 | $5 | $5 |
| Tier II - Preferred Brand copayment | $29 | $29 | $29 | $29 |
| Tier III - Specialty Drugs coinsurance | 20% | 20% | 20% | 20% |
| Tier IV - Non-Preferred Brand copayment | $59 | $59 | $59 | $59 |
| Coverage Gap | $4,550 | $4,550 | $4,550 Preferred Generics $5 copayment | $4,550 Preferred Generics $5 copayment |
 |
||||
*Partners Apex +Rx King County Premium
Benefits Comparison Chart*
*Covered services must be provided by a PSHP network provider or pharmacy for benefits to apply. For PSHP EOC's click here.
To learn more about Part D premium assistance, click here.