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Plans for CDPHP Medicare Advantage

51,660 Total Members

						Prescription Hearing Aid Coverage
Company	Plan name	Plan type	OTC Supplement	OTC Rolls Over?	Annual OTC Supplement	Coverage?	Covered Amount	Coinsurance?	Copay?	Prior Authorization?	Need Referral?	Enrollees
CDPHP Medicare Advantage	CDPHP Group Medicare Rx (HMO) H3388-803-0	HMO		No	$0	No						10,939
CDPHP Medicare Advantage	CDPHP Value Rx (HMO) H3388-004-0	HMO	$75 per Quarter	No	$300	Yes		No	Yes	No	No	9,790
CDPHP Medicare Advantage	CDPHP Choice Rx (HMO) H3388-002-0	HMO	$75 per Quarter	No	$300	Yes		No	Yes	No	No	9,730
CDPHP Medicare Advantage	CDPHP Basic RX (HMO) H3388-013-0	HMO	$75 per Quarter	No	$300	Yes		No	Yes	No	No	6,666
CDPHP Medicare Advantage	CDPHP $0 Medicare Rx (HMO) H3388-014-0	HMO	$50 per Quarter	No	$200	Yes		No	Yes	No	No	5,611
CDPHP Medicare Advantage	CDPHP Flex Rx (PPO) H5042-011-0	Local PPO	$25 per Quarter	No	$100	Yes		No	Yes	No	No	2,852
CDPHP Medicare Advantage	CDPHP Group Medicare Rx (PPO) H5042-802-0	Local PPO		No	$0	No						2,755
CDPHP Medicare Advantage	CDPHP Vital Rx (PPO) H5042-009-0	Local PPO	$25 per Quarter	No	$100	Yes		No	Yes	No	No	2,011
CDPHP Medicare Advantage	CDPHP Group Medicare (PPO) H5042-803-0	Local PPO		No	$0	No						573
CDPHP Medicare Advantage	CDPHP Choice (HMO) H3388-001-0	HMO	$75 per Quarter	No	$300	Yes		No	Yes	No	No	448
CDPHP Medicare Advantage	CDPHP Flex (PPO) H5042-012-0	Local PPO	$25 per Quarter	No	$100	Yes		No	Yes	No	No	139
CDPHP Medicare Advantage	CDPHP Group Medicare Rx (PPO) H5042-801-0	Local PPO		No	$0	No						94
CDPHP Medicare Advantage	CDPHP Group Medicare (HMO) H3388-804-0	HMO		No	$0	No						32
CDPHP Medicare Advantage	CDPHP Care Advantage (HMO C-SNP) H3388-018-0	HMO	$50 per Quarter	No	$200	Yes		No	Yes	No	No	20