Gateway Health Medicare Assured Prime (H9190-012), 2016 Health Maintenance Organization Medicare Advantage Plan, Sampson County, NC by Gateway Health.
Gateway Health Medicare Assured Prime is a Health Maintenance Organization (HMO) health insurance plan for seniors and other people with Medicare living in Sampson County, North Carolina. It includes all of the benefits of Original Medicare and may include prescription drug coverage and other extras. The primary benefit of an HMO is that the out-of-pocket costs are lower and more predictable than with other types of plans. The monthly premium is $107.00.
Please note: You must use plan providers to avoid incurring additional costs. You will be responsible for the costs of out of network care. Referrals may be required for all but primary care physician visits.
Maximum Out-of-Pocket (MOOP) Expense
All Medicare Advantage plans have a maximum out-of-pocket (MOOP) limit of $6,700. This is mandated by law. However, plans like Gateway Health Medicare Assured Prime are allowed to offer a voluntary MOOP as low as $3,400.The Gateway Health Medicare Assured Prime Medicare Advantage plan MOOP is $6,700. This figure does not include your monthly premium or the cost of your prescriptions (Part D Coverage).
What this means is that as soon as your copayments and coinsurance for doctor visits and hospital care reaches $6,700, you will no longer pay copayment or coinsurance for the remainder of the year. This is your guarantee that a critical illness or serious accident will protect you from financial liability. It's just as important as the premiums and the co-payments.When comparing Medicare Advantage plans with traditional Medicare, don't forget that you pay about twenty percent of all covered expenses, but there's no limit. That means you have a lot of risk unless you purchase a Medicare supplement policy to cover the gap.
CMS 5-Star Rating
The Centers for Medicare and Medicaid Services (CMS) rates the relative quality of all private health insurance offered through the Medicare Advantage program. The ratings are designed to assist people considering enrolling. CMS rates plans on a one to five-star scale, with five stars representing the best quality.
The Gateway Health Medicare Assured Prime Medicare Advantage plan has received a Above Average (as of 15 October, 2015).out of 5 star average rating. Overall, CMS considers this plan to be
Compare Medicare Advantage Plans
Compare Gateway Health Medicare Assured Prime with these top rated Medicare Advantage Plans available in Sampson County:
- Aetna Medicare Value Plan
- Blue Medicare PPO Enhanced
- Blue Medicare HMO Enhanced
- Blue Medicare HMO Medical Only
- Blue Medicare HMO Essential
Gateway Health Medicare Assured Prime Availability
Gateway Health Medicare Assured Prime is available in Harrells, Roseboro, Salemburg, Garland, Ivanhoe, Newton Grove, Autryville, Turkey, Godwin, Clinton, and all other locations in Sampson County.
For more information, see Medicare Advantage Plans in Sampson County, NC.