Keycareadvantage.com
Medication Therapy Management Program
WEBThe MTM program is required by the Centers for Medicare and Medicaid Services (CMS) and is not considered a benefit. This program helps you and your doctor make sure that your medications are working. It also helps us identify and reduce possible medication problems. To take part in this program, you must meet certain criteria set forth in part
Actived: 9 days ago
URL: https://keycareadvantage.com/for-members/medication-therapy-management-program/
Out-of-Network Coverage Rules
WEBThe plan covers emergency care or urgently needed care that you get from an out- of-network provider. For more information about this, and to learn what emergency or urgently needed care means, please call us at 1-844-206-1205 (TTY 711). If you need medical care that 1) Medicare requires our plan to cover, and 2) the provider in our …
Coverage Determination
WEBA coverage determination is a decision made by our plan (not the pharmacy) about your prescription drug benefits, including: Whether a drug is covered. Whether you have met all the requirements for getting a requested drug. How much you’re required to pay for a drug, and. Whether to make an exception to a plan rule when you request it.
Cancel My Enrollment
WEBWe value you as a member and want to share how your benefits will change, starting April 1,2023.Under the Part B Rebatable Drug Coinsurance Adjustment provision, beginning April 1, 2023, coinsurance for Part B rebatable drugs will be reduced, if the drug’s price has increased at a rate faster than the rate of inflation.
Organization Determination
WEBAn organization determination (OD) is a decision made by the Medicare Health Plan regarding: Receipt of, or payment for, managed care item or service; The amount a Plan requires an enrollee to pay for an item or service; or. A limit on the number of items or services. This means KeyCare Advantage will authorize, provide, or pay for medical
Join Our Network
WEBWe provide our members with exceptional benefits and an abundance of attention. And we believe KeyCare Advantage providers deserve the same. Want to learn more about joining our provider network? Give us a call at 1-844-206-1205 (TTY 771) or click the button below to email for more information on how to join. Email Us.
2024 Summary of Benefits
WEBH6959_002_2024SB_M. KeyCare Advantage Plus (HMO C-SNP) Monthly Plan Premium (includes. both medical and drugs) $0. You must continue to pay your Medicare Part B premium. Deductible. The Part B deductible was $226. This is the 2023 cost sharing amount and may change in 2024.
2023 Summary of Benefits
WEB6. KeyCare Advantage (HMO I-SNP) Mental Health Services Inpatient visit You pay the 2023 Original Medicare cost-sharing amounts. $1,600 deductible; $0 copayment each day for days 1 to 60; $400 copayment each day for days 61 to 90; $800 copayment each day for days 91 to 150 (lifetime reserve days).
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