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2016 Touchstone Health Prestige Plan HMO-SNP

To enroll in the Prestige Plan you must meet the following qualifications:

  • Must have Medicare Parts A and B
  • Enrolled in the New York State Medicaid Program
  • Do not have End-Stage Renal Disease (ESRD) (permanent kidney disease requiring dialysis or a kidney transplant), except under certain limited circumstances
  • Live in the plan’s service area: Bronx, Kings (Brooklyn), Queens, Richmond (Staten Island) and Westchester Counties, NY.

To see if you qualify for a Special Enrollment Period (SEP) click here.

You are eligible for a Special Enrollment Period if you:
  • Are new to Medicare
  • Recently moved to the area
  • Receive Medicaid
  • Get extra help paying for Medicare prescription drug coverage
  • If you recently lost your health coverage
  • Left a PACE program
2016 Touchstone Health Medicare Prestige Plan HMO-SNP
Monthly Premium $01
PCP Copay $0 copay1
Specialist Copay $0 copay1
Inpatient Hospital Care2 $0 annual deductible1
$0 copay1,3
Prescription Drug Coverage4
Tier 1 (Preferred Generic)
Tier 2 (Non-Preferred Generic)

Tier 3 (Preferred Brand)
Tier 4 (Non-Preferred Brand)
Tier 5 (Specialty)

$0, $1.20 or $2.95 copay1

$0 , $3.60 or $7.40 copay1

Preventive Dental Services $0 copay1
Routine Hearing Exam5 $0 copay1
Routine Eye Exam5 $0 copay1
Additional Benefits and Value-Added Services Fitness Benefit of $20 reimbursement per month towards eligible gym membership

Monthly Allowance for Over-the-Counter Items6
Want to learn more about the Touchstone Health Prestige Plan?
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Y0064_H3327_THPSMK_2545 (Pending Approval) Touchstone Health HMO, Inc. is a Medicare approved HMO with a Medicare Advantage Prescription Drug contract with the federal government and a contract with the New York Medicaid Program.  Enrollment in Touchstone Health depends on contract renewal.  Copayment, service area, and benefit limitations apply.  Members must use contracted providers to receive benefits except for emergency, urgent care, and out-of-area dialysis.
Information last updated 9/28/2015