HMO Not Available SNP Includes Rx
Plan Details
Plan NameKelseyCare Advantage Rx Retiree (HMO)
OrganizationKelseyCare Advantage
Legal EntityKS PLAN ADMINISTRATORS, LLC
Plan TypeHMO
Service AreaTexas
Contract IDH0332
Plan ID812
In-Network MOOP$9,350
Prescription Drug CoverageYes (Part D Included)
About This Plan
KelseyCare Advantage Rx Retiree (HMO) is a HMO Medicare plan offered by KelseyCare Advantage (KS PLAN ADMINISTRATORS, LLC). This plan is available to eligible Medicare beneficiaries in Texas.
This is a Special Needs Plan (SNP) designed for Not Available beneficiaries. This plan includes Medicare Part D prescription drug coverage.
The in-network maximum out-of-pocket (MOOP) for this plan is $9,350, which is the most you would pay for covered services in a plan year. After reaching this amount, the plan pays 100% of covered services.
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