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Zing Dual Complete Plus IN (HMO-POS D-SNP) By Zing Health



Zing Dual Complete Plus IN (HMO-POS D-SNP) H4624 016 0 is a 2023 Medicare Advantage Special Needs Plan plan by Zing Health. This plan from Zing Health 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 Zing Health and not Original Medicare. All Medicare SNPs also provide Medicare additional Part-D drug coverage. Zing Dual Complete Plus IN (HMO-POS D-SNP) H4624-016 is a Dual Eligible Special Needs Plan (D-SNP). A Dual Eligible SNP is for beneficiaries who are eligible for both Medicare and Medicaid. If you have Medicare and get help from Medicaid you can join any Medicare SNP you qualify for or switch plans at any time.







2023 Medicare Special Needs Plan Details

Plan Name:Zing Dual Complete Plus IN (HMO-POS D-SNP)
Plan ID:H4624 016 0
Special Needs Type:Dual-Eligible
Provider:Zing Health
Plan Year:2023
Plan Type:Local HMO
Monthly Premium C+D:$28.10
Part C Premium:$0
Part D (Drug) Premium:$28.10
Part D Supplemental Premium$0
Total Part D Premium:$28.10
Drug Deductible:$505.00
Tiers with No Deductible:1
Benchmark:not below the regional benchmark
Type of Medicare Health Plan:Enhanced Alternative
Drug Benefit Type:Enhanced
Gap Coverage:No
Similar Plan: H4624-018


The Zing Dual Complete Plus IN (HMO-POS D-SNP) H4624-016 is available to residents to Medicare eligible seniors in Indiana. All Medicare SNPs must provide Medicare additional prescription drug (Part-D) coverage. Zing Dual Complete Plus IN (HMO-POS D-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.



How much does Zing Dual Complete Plus IN (HMO-POS D-SNP) cost?


Part-C Premium

A monthly premium is the fee you pay to the plan in exchange for coverage. Zing Health charges a $0 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.


Part-D Deductible and Premium

An annual deductible is the amount you pay out-of-pocket for your prescription drugs before your plan begins to pay. Zing Dual Complete Plus IN (HMO-POS D-SNP) has a monthly drug premium of $28.10 and a $505.00 drug deductible. This Zing Health plan offers a $28.10 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. This Premium covers any enhanced plan benefits offered by Zing Health 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 $28.10. The Part D Total Premium is the addition of supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.


Zing Health Gap Coverage

In 2023 once you and your plan provider have spent $4660 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 Zing Health plan does not offer additional coverage through the gap.


Extra Help Premium Assistance

The Low Income Subsidy (LIS) Extra Helps people with Medicare pay for prescription drugs and lowers the costs of Medicare prescription drug coverage. Income limits are based on the Federal Poverty Level (FPL), which changes every year in February or March. The 2022 income limit is $1,719 ($2,309 for couples) per month. Depending on your income level you may be eligible for a full 75%, 50%, 25% premium assistance. The Zing Dual Complete Plus IN (HMO-POS D-SNP) medicare insurance offers a $0 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $7.00 for 75% low-income subsidy $14.00 for 50% and $21.10 for 25%.


Full Assistance Premium:$0
75% Assistance Premium:$7.00
50% Assistance Premium:$14.00
25% Assistance Premium:$21.10


H4624-016 Formulary and Drug Coverage

Zing Dual Complete Plus IN (HMO-POS D-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 Special Needs Plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price.

Drug Tier Copay
Preferred
Pharmacy		 Copay
Nonpreferred
Pharmacy
Tier 1 NA $0
Tier 2 NA 25%
Tier 3 NA 25%
Tier 4 NA 25%
Tier 5 NA 25%
The complete Zing Dual Complete Plus IN (HMO-POS D-SNP) H4624-016 Formulary
*Initial Coverage Phase and 30 day supply





2023 Summary of Benefits

The benefit information provided is a summary of what Zing Dual Complete Plus IN (HMO-POS D-SNP) covers and what you pay (such as copayments and coinsurance amounts) for certain common medical events. The Summary of Benefits from Zing Health helps get an idea of how much financial protection the plan is generally expected to provide for common health conditions. This section also contains information on coverage for in-network and out-of-network providers.

Wellness programs (e.g., fitness, nursing hotline)Covered


Contact lenses


In-Network Vision$0 copay


Eyeglass frames


In-Network Vision$0 copay


Eyeglass lenses


In-Network Vision$0 copay


Eyeglasses (frames and lenses)


In-Network Vision$0 copay


Other


VisionNot covered


Routine eye exam


In-Network Vision$0 copay


Upgrades


VisionNot covered



In-Network Transportation$0 copay
In-Network Skilled Nursing Facility$0 copay
Out-of-Network Skilled Nursing FacilityIn 2023 the amounts for each benefit period are:
$0 copay for days 1 through 20
$200 copay per day for days 21 through 100


Occupational therapy visit


Out-of-Network Rehabilitation services20% coinsurance
In-Network Rehabilitation services$0 copay


Physical therapy and speech and language therapy visit


In-Network Rehabilitation services$0 copay
Out-of-Network Rehabilitation services20% coinsurance


Cleaning


Preventive dentalCovered under office visit


Dental x-ray(s)


Preventive dentalCovered under office visit


Fluoride treatment


Preventive dentalCovered under office visit


Office visit


In-Network Preventive dental$0.00


Oral exam


Preventive dentalCovered under office visit



Out-of-Network Preventive care$0 copay
In-Network Preventive care$0 copay
Out-of-Network Outpatient hospital coverage20% coinsurance per visit
In-Network Outpatient hospital coverage$0 copay
In-Network Other health plan deductibles?No
Optional supplemental benefitsNo


Inpatient hospital - psychiatric


In-Network Mental health services$0 copay
Out-of-Network Mental health servicesIn 2023 the amounts for each benefit period are:
$1,600 deductible for days 1 through 60
$400 copay per day for days 61 through 90


Outpatient group therapy visit


In-Network Mental health services$0 copay
Out-of-Network Mental health services20% coinsurance


Outpatient group therapy visit with a psychiatrist


In-Network Mental health services$0 copay
Out-of-Network Mental health services20% coinsurance


Outpatient individual therapy visit


Out-of-Network Mental health services20% coinsurance
In-Network Mental health services$0 copay


Outpatient individual therapy visit with a psychiatrist


Out-of-Network Mental health services20% coinsurance
In-Network Mental health services$0 copay


Chemotherapy


In-Network Medicare Part B drugs$0 copay
Out-of-Network Medicare Part B drugs20% coinsurance


Other Part B drugs


Out-of-Network Medicare Part B drugs20% coinsurance
In-Network Medicare Part B drugs$0 copay


Diabetes supplies


Out-of-Network Medical equipment/supplies20% coinsurance per item
In-Network Medical equipment/supplies$0 copay


Durable medical equipment (e.g., wheelchairs, oxygen)


In-Network Medical equipment/supplies$0 copay
Out-of-Network Medical equipment/supplies20% coinsurance per item


Prosthetics (e.g., braces, artificial limbs)


In-Network Medical equipment/supplies$0 copay
Out-of-Network Medical equipment/supplies20% coinsurance per item



Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$8,300 In and Out-of-network
$8,300 In-network
Out-of-Network Inpatient hospital coverageIn 2023 the amounts for each benefit period are:
$1,600 deductible for days 1 through 60
$400 copay per day for days 61 through 90
In-Network Inpatient hospital coverage$0 copay


Fitting/evaluation


In-Network Hearing$0 copay


Hearing aids - inner ear


In-Network Hearing$0 copay


Hearing aids - outer ear


In-Network Hearing$0 copay


Hearing aids - over the ear


In-Network Hearing$0 copay


Hearing exam


Out-of-Network Hearing20% coinsurance
In-Network Hearing$0 copay



Health plan deductible$0
In-Network Ground ambulance$0 copay


Foot exams and treatment


In-Network Foot care (podiatry services)$0 copay
Out-of-Network Foot care (podiatry services)20% coinsurance


Routine foot care


In-Network Foot care (podiatry services)$0 copay


Emergency


Emergency care/Urgent care$0 copay


Urgent care


Emergency care/Urgent care$0 copay


Primary


In-Network Doctor visits$0 copay


Specialist


In-Network Doctor visits$0 copay
Out-of-Network Doctor visits20% coinsurance per visit


Diagnostic radiology services (e.g., MRI)


In-Network Diagnostic procedures/lab services/imaging$0 copay
Out-of-Network Diagnostic procedures/lab services/imaging20% coinsurance


Diagnostic tests and procedures


Out-of-Network Diagnostic procedures/lab services/imaging20% coinsurance
In-Network Diagnostic procedures/lab services/imaging$0 copay


Lab services


Out-of-Network Diagnostic procedures/lab services/imaging20% coinsurance
In-Network Diagnostic procedures/lab services/imaging$0 copay


Outpatient x-rays


In-Network Diagnostic procedures/lab services/imaging$0 copay
Out-of-Network Diagnostic procedures/lab services/imaging20% coinsurance


Diagnostic services


In-Network Comprehensive dental$0 copay


Endodontics


In-Network Comprehensive dental$0 copay


Extractions


In-Network Comprehensive dental$0 copay


Non-routine services


In-Network Comprehensive dental$0 copay


Periodontics


In-Network Comprehensive dental$0 copay


Prosthodontics, other oral/maxillofacial surgery, other services


In-Network Comprehensive dental$0 copay


Restorative services


In-Network Comprehensive dental$0 copay



In-Network Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?No




Coverage Area

(Click county or state to compare all available Advantage plans)

The availability of Medicare Special Need Plans will vary according to your region. This is why the Coverage Area matters in terms of Medicare eligibility. You will always be eligible for Original Medicare, but eligibility for Zing Dual Complete Plus IN (HMO-POS D-SNP) requires you to live in that plan’s service area. The service area is listed below:

State: Medicare Indiana
County:SNP in Allen

SNP in Lake

SNP in Marion





Source: CMS.

Plans as of Oct 1, 2022.

Last updated on

Notes: Data are subject to change. All contracts for 2023 have not been finalized. For 2023, 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 2023 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.

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