General News
Published April 14, 2022
Deliver the greatest value to your clients
Members of our Medicare Advantage (MA) Classic HMO or Total Health HMO value their plans due to the robust benefit offerings for a low monthly premium.
When working with new clients, we encourage you to educate them on the benefits and value an HMO plan can offer, such as:
| Plan benefits |
2022 Classic HMO Western WA and Walla Walla/ 2022 Total Health HMO, Eastern WA |
| Monthly plan premium |
Classic HMO: $55/Total Health HMO: $24 |
| Annual deductible/max out of pocket |
$0/$5,000 |
| PCP/specialist visits |
$0/$30 copay |
| Inpatient hospital care |
$350 copay (days 1–4)/$0 copay (days 5+) |
| Ambulatory surgery center (ASC)/outpatient hospital |
Classic HMO: $250/$300 copays
Total Health: $250/$275 copays |
| Diagnostic testing/radiology |
$30/$160 copays |
| Routine chiropractic/acupuncture |
$20 copay (10 per year) for each |
| Routine naturopathic services |
$30 copay (6 per year) |
| Routine eye exam/vision hardware |
Classic HMO: $0 copay/$250 per year
Total Health: $0 copay/$200 per year
|
| Dental: Preventive and comprehensive |
$1,500 annual maximum
$75 annual comprehensive benefit deductible
|
| Over- the- counter (OTC) benefit |
$50 per quarter |
| Hearing aid allowance (Hearing Care Solutions only) |
$1,000 per ear, per year |
| Drug deductible for tiers 4-5 Note: over 1,000 drugs added to our formulary, with many others moved to lower tiers. |
$0 |
Help your clients see what an excellent value these plans are. To see the full list of benefits for all plans, check out our Summary of Benefits.
If you need any help or have questions, reach out to your territory manager.