With some of the lowest out-of-pocket costs in the state.

All $0 Premium Medicare plans are not the same. If you're not careful, you could get stuck with higher than expected
out-of-pocket costs. A $0 per month2 plan from VIVA MEDICARE Plus comes with money saving features throughout. Call us today to get a plan that is designed to keep more money in your pocket, not out.

Need help choosing a plan? Call us today at 1-888-830-VIVA (8482) or click here to contact us.

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 Amount You Pay

2012 VIVA MEDICARE
Plus Rx3,4		 2012 VIVA MEDICARE
Plus Select3,4		 2012 VIVA MEDICARE
Plus Rx Extra Value * **

Full Medicaid, QMB, SLMB+
QDWI,QII,SLMB only
Premium $0 (Must still pay Part B premium)2 $0 (Must still pay Part B premium)2 $0 in addition to Part B monthly premium (Cost sharing based on Medicaid eligibility)
Annual Out of Pocket Limit $6,700 $6,700 $6,700 $6,700
Inpatient Copay (includes IP Psych) $235/day for days 1-6;
$0/day for days 7-90.		 $150/day for days 1-6;
$0/day for days 7-90.		 $0
 $125/day for days 1-6;
$0/day for days 7-90.
SNF Copay $50/day for days 1-100. $50/day for days 1-50;
$0/day for days 51-100.		 $0 $30/day for days 1-30;
$0/day for days 31-100.
PCP Copay $20 $15 $0 $0
Specialist Copay $40 $25 $0 $10
Outpatient mental health/sub abuse $40 $25 $0 $0
Outpatient Surgery Copay $350 per procedure
 $250 per procedure
 $0 per procedure
 $75 per procedure
Ambulance Services $200 $150 $0 $50
ER Visit $65 (Waived if admitted to hospital within 24 hours) $65 (Waived if admitted to hospital within 24 hours) $0 $65
Urgent Care $20-$40 $15-$30 $0 $10
Outpatient Rehab $40 $30 $0 $10
DME/prosthetics 20% 20% $0 10%
Lab Copay $0 $0 $0 $0
Diagnostic procedures/tests $0 $0 $0 $0
X-Ray Copay $20 $0 $0 $0
Diagnostic Radiology $40 $40 $0 $0
Radiation Therapy $40 $40 $0 $0
Part D Deductible $125 N/A $0 $0
Prescription Coverage1,5 Yes N/A Cost sharing depends on income and institutional status
1-Preferred Generics $5 N/A $0, $1.10, $2.50
2-Generics $10 N/A $0, $1.10, $2.50
3-Preferred Brand $45 N/A $0, $3.30, $6.30
4-Non-Preferred Brand $75 N/A $0, $3.30, $6.30
5-Specialty 29% N/A $0, $3.30, $6.30
Prescription Gap Coverage Member pays 86% for generics on Tiers 1,
2, & 5. There is also a 50% discount on the
negotiated price (excluding the dispensing
fee) for those brand name drugs from
manufacturers that have agreed to pay the
discount. Tier 5 will only be covered up to a
31 day supply.		 N/A All drugs covered through the gap*
Health/Wellness Education $20 per month at a participating health club $20 per month at a participating health club $20 per month at a participating health club

This table is a brief comparison of copays for frequently used benefits among the $0 premium plans offered by VIVA MEDICARE Plus. Click here to see them. Another plan not shown here with a monthly premium is available if you would like a plan with lower copays. This is a summary only. For complete details on plan benefits and limitations, please see the Evidence of Coverage.

 

1You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office

2You must continue to pay your Part B premium.  Individuals must have both Part A and Part B to enroll

3Limitations, copayments, and restrictions may apply. View the Evidence of Coverage for more information.

4You must use plan providers except in an emergency, urgent care situations, or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor VIVA MEDICARE Plus will be responsible for the costs.

5 VIVA MEDICARE Plus Rx Extra Value is a Coordinated Care plan with a Medicare Advantage contract and a contract with the Alabama Medicaid program.

*Premiums, copays, coinsurance, and deductibles may vary based on the level of help received

**These plans ONLY available if you have Medicare and Medicaid (Full Medicaid, QMB/QMB+, SLMB/SLMB+, QDWI, QI-I)