See your county’s
plan options.

4 Plans Available for 2022
Medical Rx
PCP: $0
Specialist: $25

Generics starting at $0; No annual deductible; 25% for generics and brand name in the Coverage Gap.

Monthly Premium: $0

Inpatient Hospital
$290 per day, days 1-6; $0 additional days; waived for treatment of COVID-19
Outpatient Services
$200-275 ($0 for colonoscopies)
Over the Counter (OTC)
$40 allowance per calendar quarter
Dental
$700 annual dental allowance
Eyewear
$100 annual eyewear allowance
Fitness
The Silver&Fit® Program; No cost

PCP: $0
Specialist: $20

Generics starting at $0; No annual deductible; 25% for generics and brand name in the Coverage Gap.

Monthly Premium: $55

Inpatient Hospital
$245 per day, days 1-6; $0 additional days; waived for treatment of COVID-19
Outpatient Services
$195-225 ($0 for colonoscopies)
Over the Counter (OTC)
$60 allowance per calendar quarter
Dental
$1200 annual dental allowance
Eyewear
$150 annual eyewear allowance
Fitness
The Silver&Fit® Program; No cost

PCP: $0
Specialist: $15

Generics starting at $0; No annual deductible; 25% for generics and brand name in the Coverage Gap.

Monthly Premium: $105

Inpatient Hospital
$195 per day, days 1-6; $0 additional days; waived for treatment of COVID-19
Outpatient Services
$125-$175 ($0 for colonoscopies)
Over the Counter (OTC)
$90 allowance per calendar quarter
Dental
$1,600 annual dental allowance
Eyewear
$200 annual eyewear allowance
Fitness
The Silver&Fit® Program; No cost

PCP: $0
Specialist: $15

None

Monthly Premium: $0

Inpatient Hospital
$245 per day, days 1-6; $0 additional days; waived for treatment of COVID-19
Outpatient Services
$195-$225 ($0 for colonoscopies)
Over the Counter (OTC)
$100 allowance per calendar quarter
Part B Benefit
$50 monthly buy down of Part B Premium
Dental
$2000 annual dental allowance
Eyewear
$150 annual eyewear allowance
Fitness
The Silver&Fit® Program; No cost

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