Page 35 - APPENDICES for Janet Tuma
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In-home support services
      Not covered




      Home and bathroom safety devices
      Not covered




      Meals for short duration

      Some coverage




      Annual physical exams
      Some coverage




      Telehealth
      Some coverage




      Worldwide emergency

      Some coverage







   Drug coverage & costs




   See if there's help to lower costs for drugs you take.






      Plans group their drug lists into tiers. The table below shows your portion of the drug cost in certain
      tiers based on which coverage phase you're in for this plan

      Learn more about drug tiers





   TIER DRUG COST FOR

      Preferred retail pharmacy drug cost for 1-month





                           Initial coverage          Gap coverage
     Tiers                                                                    Catastrophic coverage phase
                           phase                     phase  1
   30   31   32   33   34   35   36   37   38   39   40