Maximum Out-of-Pocket (MOOP) Expense
The new healthcare law allows for a maximum limit of $6,700 on your out of pocket medical costs for 2018 Medicare Advantage plans. This amount is commonly called the plan MOOP (Maximum Out of Pocket). A plan's MOOP does not include your prescriptions or the monthly premiums you pay for your health plan.
Although the mandatory MOOP limit is $6,700, the Affordable Care Act law allows for a “Voluntary MOOP” that can be as low as $3,400. The MOOP on this plan is N/A. You need to take this figure into as much consideration as the premiums and the co-payments.
If you are comparing this Medicare Advantage plan with your Original Medicare benefits, take into consideration that the government does not have out-of-pocket limits on Medicare Parts A and B. With traditional Medicare the only way to protect yourself is to purchase a Medigap insurance policy to supplement your coverage.
CMS 5-Star Rating
After its first year on the market, each Medicare Advantage plan receives a one to five star rating from the Centers for Medicare and Medicaid Services (CMS). The relative quality assessment of health insurance by CMS assists people who are considering enrollment. Plans with five stars represent the highest quality, whereas a one star plan has the worst quality.
The SWH Whole Health FIDA Medicare Advantage plan is new and has not yet been rated by CMS. This is why the plan's rating is listed as out of 5 stars (as of 15 October, 2015).
Compare Medicare Advantage Plans
Compare SWH Whole Health FIDA with these top rated Medicare Advantage Plans available in Queens County:
- Empire MediBlue Core
- Empire MediBlue Plus
- Aetna Medicare Standard Plan
- Aetna Medicare Elite Plan
- UnitedHealthcare MedicareComplete Choice Plan 1
SWH Whole Health FIDA Availability
SWH Whole Health FIDA is available in Breezy Point, Fresh Meadows, Whitestone, Corona, Hollis, Ozone Park, Sunnyside, Cambria Heights, Queens Village, South Ozone Park, Long Island City, Woodhaven, Richmond Hill, Arverne, Astoria, Elmhurst, South Richmond Hill, Bellerose, East Elmhurst, Oakland Gardens, Howard Beach, College Point, Maspeth, Saint Albans, Glen Oaks, Forest Hills, Rego Park, Woodside, Jamaica, Bayside, Rosedale, Far Rockaway, Middle Village, Little Neck, Kew Gardens, Springfield Gardens, Ridgewood, Jackson Heights, Floral Park, Flushing, Rockaway Park, and all other locations in Queens County.
For more information, see Medicare Advantage Plans in Queens County, NY.