Page 40 - APPENDICES for Vic Bosiger
P. 40
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OPTIMA MEDICARE
Optima Medicare Value (HMO)
Plan type: Medicare Advantage with drug coverage Call this number to
enroll
Plan ID: H2563-009-0
Plan website Non-members: 1-844-563-4201 Members: 1-800-927-6048
Open Enrollment starts October 15
What you'll pay
Total monthly Health Primary 2022 estimated total drug costs (lowest cost
premium deductible doctor pharmacy)
$0.00 $0.00 $0 $2,973.24
copay Covers 14 of 14 drugs
Overview
PREMIUMS
Total monthly premium $0.00
Health premium $0.00
Drug premium $0.00
Standard Part B premium $148.50
Part B premium reduction No
