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Compare Plans
This chart compares our 2008 plans to original Medicare for some frequently used services. Please review the Summary of Benefits for a complete comparison.
Original Medicare Compared with VIVA Medicare Plus Rx & Healthy Lifestyles
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PlusRx Summary of Benefits
HLife Summary of Benefits
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| Premium |
Medicare Part B premium of $96.40/month |
$0 beyond Medicare Part B premium of $96.40/month |
| Inpatient Hospital Care |
You pay for each benefit period:3 Days 1-60: an initial deductible of $1,024 Days 61-90: $256 each day Days 91-150: $512 each lifetime reserve day.4
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$200 for each Medicare covered stay5 in a network hospital. No copayment for additional days in a network hospital - unlimited days each benefit period.
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| Doctor Office Visits |
You pay 20% of Medicare approved amounts. 1,2 |
You pay $10 for each primary care doctor visit5 for Medicare covered services. $15 for each specialist visit5 for Medicare covered services. |
| Outpatient Surgery |
You pay 20% of Medicare approved amounts for the doctor.1,2 You pay 20% of outpatient facility charges.1,2
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$175 for each Medicare covered visit5 to an ambulatory surgical center. $175 for each Medicare covered visit5 to an outpatient hospital facility.
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| Extra Benefits |
N/A |
Unlimited hospital days, world-wide emergency coverage, $20 per month toward dues at participating health clubs |
Medicare Part D Prescription Drug Benefit |
Most drugs not covered. (You can add prescription drug coverage to Original Medicare by joining a Medicare Prescription Drug Plan.) |
Included |
Original Medicare Compared with VIVA Medicare Plus Select
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Summary of Benefits |
| Premium |
Medicare Part B premium of $96.40/month |
$0 beyond Medicare Part B premium of $96.40/month |
| Inpatient Hospital Care |
You pay for each benefit period:3 Days 1-60: an initial deductible of $1,024 Days 61-90: $256 each day Days 91-150: $512 each lifetime reserve day.4
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$150 for each Medicare covered stay5 in a network hospital. No copayment for additional days in a network hospital - unlimited days each benefit period.
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| Doctor Office Visits |
You pay 20% of Medicare approved amounts. 1,2 |
You pay $5 for each primary care doctor visit5 for Medicare covered services. $10 for each specialist visit5 for Medicare covered services. |
| Outpatient Surgery |
You pay 20% of Medicare approved amounts for the doctor.1,2 You pay 20% of outpatient facility charges.1,2
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$125 for each Medicare covered visit5 to an ambulatory surgical center. $125 for each Medicare covered visit5 to an outpatient hospital facility.
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| Extra Benefits |
N/A |
Same as VIVA Medicare Plus Rx plus $100 for contacts or glasses and one dental exam and cleaning each year. |
Medicare Part D Prescription Drug Benefit |
Most drugs not covered. (You can add prescription drug coverage to Original Medicare by joining a Medicare Prescription Drug Plan.) |
Not Included |
Footnotes:
- Each year, you pay a total of one $135 deductible.
- If a doctor or supplier chooses not to accept assignment, their costs are often higher, which means you may pay more.
- A benefit period begins the day you go to a hospital or skilled care nursing facility. The benefit period ends when you have not received hospital or skilled nursing care for 60 days in a row. If you go into the hospital after one benefit period has ended, a new benefit period begins. You must pay the inpatient hospital deductible for each benefit period. There is no limit to the number of benefit periods you can have.
- Lifetime reserve days can be used only once.
- Under a special agreement with the Alabama Medicaid Agency, members with both Medicare and Medicaid do not pay the doctor and hospital copays listed above.
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