Amerivantage ESRD Care (HMO C-SNP) By Amerigroup Community Care of New Mexico

Amerivantage ESRD Care (HMO C-SNP) is a 2022 Medicare Advantage Special Needs Plan plan by Amerigroup Community Care of New Mexico. This plan from Amerigroup Community Care of New Mexico works with Medicare to give you significant coverage beyond original Medicare. If you decide to sign up you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Amerigroup Community Care of New Mexico and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. Amerivantage ESRD Care (HMO C-SNP) H5746-019 is a Chronic Condition SNP (C-SNP). A Chronic Condition SNP is for beneficiaries with the following severe or disabling chronic conditions: Chronic Lung Disorders. If you have Medicare and you develop certain severe or disabling conditions you can join a Medicare SNP designed to serve people with those conditions at any time.

2022 Medicare Special Needs Plan Details

The Amerivantage ESRD Care (HMO C-SNP) H5746-019 is available to residents in New Mexico, and all Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. Amerivantage ESRD Care (HMO C-SNP) is a Local HMO. With a health maintenance organization (HMO) you will be required to receive most of your health care from an in-network provider. Health maintenance organizations require that you select a primary care physician (PCP). Your PCP will serve as your personal doctor to provide all of your basic healthcare services. If you need special care for a physician specialist, your primary care physician will make the arrangements and tell you where you can go in the network. You will need your PCPs okay, called a referral. Without getting a referral or services received from out-of-network providers are not typically covered by the plan.

Gap Coverage

In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for brand-name drugs and 25% on generic drugs unless your plan offers additional coverage. This Amerigroup Community Care of New Mexico plan offer additional coverage through the gap.

Amerivantage ESRD Care (HMO C-SNP) Part-C Premium

Amerigroup Community Care of New Mexico plan charges a Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

H5746-019 Part-D Deductible and Premium

Amerivantage ESRD Care (HMO C-SNP) has a monthly drug premium of $0.00 and a $0.00 drug deductible. This Amerigroup Community Care of New Mexico plan offers a $0.00 Part D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Amerigroup Community Care of New Mexico above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $0.00 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lower due to negative basic or supplemental premiums.

Amerigroup Community Care of New Mexico Gap Coverage

In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Amerigroup Community Care of New Mexico plan offer additional coverage through the gap.

H5746-019 Formulary or Drug Coverage

Amerivantage ESRD Care (HMO C-SNP) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 Amerivantage ESRD Care (HMO C-SNP) H5746-019 Formulary here.

Reviews for Amerivantage ESRD Care (HMO C-SNP) H5746

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in Amerivantage ESRD Care (HMO C-SNP) Plans Performance

Health Plan Customer Service Rating for Amerivantage ESRD Care (HMO C-SNP)

Amerivantage ESRD Care (HMO C-SNP) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Drug Safety and Accuracy of Drug Pricing

Coverage Area for Amerivantage ESRD Care (HMO C-SNP)

Source: CMS.

Plans as of September 1, 2021.

Notes: Data are subject to change. All contracts for 2022 have not been finalized. For 2022, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part Part D benefit.

Includes 2022 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.