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- Grundy County, TN
Medicare Advantage Plans in Grundy County, TN
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Devoted CHOICE GIVEBACK Tennessee (PPO)Summary of Benefits (PDF)Updated September 12, 2024 | Devoted CORE Tennessee (HMO)Summary of Benefits (PDF)Updated September 12, 2024 | Devoted CHOICE Tennessee (PPO)Summary of Benefits (PDF)Updated September 12, 2024 | |
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Monthly premium | $0 | $0 | $0 |
Part B premium reduction | $172.70 per month back in your Social Security check | None | None |
Annual out-of-pocket maximum | $8,300*, in-network $10,000, in- and out-of-network | $4,500* | $5,500*, in-network $8,950, in- and out-of-network |
Food & Home CardPre-loaded card for purchase of food, over-the-counter, utilities, and mortgage or rent.** | Not covered | $117 per month | $82 per month |
Dental & Eyewear | $250 per year for dental and eyewear coverage, for use at any dentist or eyewear retailer | $1,000 per year for dental and eyewear coverage, for use at any dentist or eyewear retailer | $1,000 per year for dental and eyewear coverage, for use at any dentist or eyewear retailer |
Primary care provider (PCP) visits | $0 copay*, in-network $0 copay, out-of-network | $0 copay* | $0 copay*, in-network $0 copay, out-of-network |
Specialist visitsCost shares for Balance Exams with a Specialist may differ. See your Summary of Benefits for details. | $50 copay*, in-network $50 copay, out-of-network | $30 copay* | $35 copay*, in-network $35 copay, out-of-network |
Inpatient hospital stays | In-network*: | In-network*:
| In-network*: |
Pharmacy (Part D) Deductible | $590 for Tiers 3-5 only If you receive Extra Help from Medicare, your deductible is $0. The deductible does not apply to covered Part D insulins and most adult Part D vaccines. | $590 for Tiers 3-5 only If you receive Extra Help from Medicare, your deductible is $0. The deductible does not apply to covered Part D insulins and most adult Part D vaccines. | $590 for Tiers 3-5 only If you receive Extra Help from Medicare, your deductible is $0. The deductible does not apply to covered Part D insulins and most adult Part D vaccines. |
30-Day Supply Retail PharmacyFor Part D prescriptions. If you get Extra Help from Medicare, your costs may be lower. |
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*When you use an in-network provider or pharmacy.
Next Steps
Now that you know what our plans are all about, you can:
- See if your doctors are in our network
- Make sure we cover your medications
And if you have any questions, call us at (1-800-990-0723) (TTY 711) You can also see and compare more plan options at www.Medicare.gov.