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Touchstone Health Medicare Advantage Plans in Richmond County (Staten Island), New York

NOTE TO TOUCHSTONE HEALTH PLAN APPLICANTS:

Members may enroll in the plan only during specific times of the year. Contact Touchstone Health for more information.
Individuals must have both Part A and Part B to enroll. Click here to download an Enrollment Form. Upon submission of your online application, please complete the Coordination of Benefit forms and send to: Touchstone Health, Attn: Enrollment, 365 Harry L. Drive, Suite 120, Johnson City, NY 13790

We offer 5 Plans in your service area.

2014 Touchstone Health Medicare Power Plan  MA-PD / Health Maintenance Organization (HMO)
Monthly Premium: $0
Geographic Coverage:   Richmond County
Monthly Premium: $0
PCP Copay: $0 copay
Specialist Copay: $15 copay
Includes: Over the Counter Benefits

More Info  More Information
In-Network Out-of-Pocket Maximum: $3400 In-Network
Inpatient Hospital Care2: Days 1-10: $100 copay per day
Days 11-90: $0 copay per day3
Coverage in Coverage Gap: After your total yearly drug costs reach $2,850, you pay 72% of the plan's costs for generic drugs until your yearly out-of-pocket costs reach $4,550. You receive a discount on brand name drugs until your yearly out-of-pocket drug costs reach $4,550.
Tier 1 (Generic) Copay5: $5 copay
Tier 2 (Preferred Brand) Copay5: $45 copay
Tier 3 (Non-Preferred Brand) Copay5: $80 copay
Tier 4 (Specialty Tier Drugs) Copay5: 33% coinsurance
 
Other Benefits
Preventive Dental Services: $0 copay
Routine Hearing Exam4: $20 copay
Routine Eye Exam4: $0 copay for routine
Over the Counter Benefit: get $15 per month
Transportation: not covered
Fitness: yes
Complementary Alternative Medicine: yes
Brain Games: yes
Other Benefits:
1 Based on your level of Medicaid eligibility.
2 Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
3 $0 copay for additional hospital days.
4 Up to 1 routine exam / yr.
5 Based on supply for one month (30-day) retail pharmacy.
6 Members should review their Summary of Benefits for details on coverage depending on Medicaid eligibility.
 
2014 Touchstone Health Medicare Total Plan  MA-PD / Health Maintenance Organization (HMO)
Monthly Premium: $37.20
Geographic Coverage:   Richmond County
Monthly Premium: $37.20
PCP Copay: $0 copay
Specialist Copay: $10 copay
Includes: Over the Counter & Transportation Benefits

More Info  More Information
In-Network Out-of-Pocket Maximum: $3400 In-Network
Inpatient Hospital Care2: Days 1-7: $100 copay per day
Days 8-90: $0 copay per day3
Coverage in Coverage Gap: After your total yearly drug costs reach $2,850, you pay 72% of the plan's costs for generic drugs until your yearly out-of-pocket costs reach $4,550. You receive a discount on brand name drugs until your yearly out-of-pocket drug costs reach $4,550.
Tier 1 (Generic) Copay5: $0 copay
Tier 2 (Preferred Brand) Copay5: $40 copay
Tier 3 (Non-Preferred Brand) Copay5: $80 copay
Tier 4 (Specialty Tier Drugs) Copay5: 33% coinsurance
 
Other Benefits
Preventive Dental Services: $0 copay
Routine Hearing Exam4: $20 copay
Routine Eye Exam4: $0 copay for routine
Over the Counter Benefit: get $25 per month
Transportation: $0 copay for up to 36 one way trip(s) to plan-approved location every year
Fitness: yes
Complementary Alternative Medicine: yes
Brain Games: yes
Other Benefits:
1 Based on your level of Medicaid eligibility.
2 Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
3 $0 copay for additional hospital days.
4 Up to 1 routine exam / yr.
5 Based on supply for one month (30-day) retail pharmacy.
6 Members should review their Summary of Benefits for details on coverage depending on Medicaid eligibility.
 
2014 Touchstone Health Medicare Clear Plan  MA Only / Point of Service (HMO-POS)
Monthly Premium: $0
Geographic Coverage:   Richmond County
Monthly Premium: $0
PCP Copay: $5 copay
Specialist Copay: $10 copay
Point-of-Service Plan: No prescription drug coverage
Option to see doctors in and out of network

More Info  More Information
In-Network Out-of-Pocket Maximum: $3400 In-Network / $5100 Out-of-Network
Inpatient Hospital Care2: Days 1-5: $50 copay per day
Days 6-90: $0 copay per day3
Coverage in Coverage Gap: Not Applicable
Tier 1 (Generic) Copay5: Not Applicable
Tier 2 (Preferred Brand) Copay5: Not Applicable
Tier 3 (Non-Preferred Brand) Copay5: Not Applicable
Tier 4 (Specialty Tier Drugs) Copay5: Not Applicable
 
Other Benefits
Preventive Dental Services: $0 copay
Routine Hearing Exam4: $20 copay
Routine Eye Exam4: $0 copay for routine
Over the Counter Benefit: get $15 per month
Transportation: not covered
Fitness: yes
Complementary Alternative Medicine: yes
Brain Games: yes
Other Benefits:
1 Based on your level of Medicaid eligibility.
2 Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
3 $0 copay for additional hospital days.
4 Up to 1 routine exam / yr.
5 Based on supply for one month (30-day) retail pharmacy.
6 Members should review their Summary of Benefits for details on coverage depending on Medicaid eligibility.
 
2014 Touchstone Health Medicare Freedom Plan  MA-PD / Point of Service (HMO-POS)
Monthly Premium: $0
Geographic Coverage:   Richmond County
Monthly Premium: $0
PCP Copay: $15 copay
Specialist Copay: $25 copay
Point-of-Service Plan: Option to see doctors in and out of network

More Info  More Information
In-Network Out-of-Pocket Maximum: $3400 In-Network / $5100 Out-of-Network
Inpatient Hospital Care2: Days 1-5: $150 copay per day
Days 6-90: $0 copay per day3
Coverage in Coverage Gap: After your total yearly drug costs reach $2,850, you pay 72% of the plan's costs for generic drugs until your yearly out-of-pocket costs reach $4,550. You receive a discount on brand name drugs until your yearly out-of-pocket drug costs reach $4,550.
Tier 1 (Generic) Copay5: $6 copay
Tier 2 (Preferred Brand) Copay5: $40 copay
Tier 3 (Non-Preferred Brand) Copay5: $80 copay
Tier 4 (Specialty Tier Drugs) Copay5: 33% coinsurance
 
Other Benefits
Preventive Dental Services: $0 copay
Routine Hearing Exam4: $20 copay
Routine Eye Exam4: $0 copay for routine
Over the Counter Benefit: not covered
Transportation: not covered
Fitness: yes
Complementary Alternative Medicine: yes
Brain Games: yes
Other Benefits:
1 Based on your level of Medicaid eligibility.
2 Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
3 $0 copay for additional hospital days.
4 Up to 1 routine exam / yr.
5 Based on supply for one month (30-day) retail pharmacy.
6 Members should review their Summary of Benefits for details on coverage depending on Medicaid eligibility.
 
2014 Touchstone Health Medicare Prestige Plan  SNP / Medicaid Advantage / Special Needs Plan (HMO-SNP)
Monthly Premium:
Geographic Coverage:   Richmond County
Monthly Premium:
PCP Copay: $0 copay1
Specialist Copay: $0 copay1
Includes: Over the Counter Benefits

More Info  More Information
In-Network Out-of-Pocket Maximum: $3400 In-Network
Inpatient Hospital Care2: $0 yearly deductible1; $0 copay1
Coverage in Coverage Gap: Generics1 - $0 copay; or $1.20 copay; or $2.55 copay
Brand1 - $0 copay; or $3.60 copay; or $6.35 copay
Tier 1 (Generic) Copay5: $0 copay; or $1.20 copay; or $2.55 copay1
Tier 2 (Preferred Brand) Copay5: $0 copay; or $3.60 copay; or $6.35 copay1
Tier 3 (Non-Preferred Brand) Copay5: $0 copay; or $3.60 copay; or $6.35 copay1
Tier 4 (Specialty Tier Drugs) Copay5: $0 copay; or $3.60 copay; or $6.35 copay1
 
Other Benefits
Preventive Dental Services: $0 copay1
Routine Hearing Exam4: $0 copay1
Routine Eye Exam4: $0 copay for routine1
Over the Counter Benefit: get $77 per month
Transportation: covered under medicaid services
Fitness: yes
Complementary Alternative Medicine: yes
Brain Games: yes
Other Benefits:
1 Based on your level of Medicaid eligibility.
2 Except in an emergency, your doctor must tell the plan that you are going to be admitted to the hospital.
3 $0 copay for additional hospital days.
4 Up to 1 routine exam / yr.
5 Based on supply for one month (30-day) retail pharmacy.
6 Members should review their Summary of Benefits for details on coverage depending on Medicaid eligibility.
 
To discuss Touchstone Health’s Medicare Advantage plan options with a live representative or to schedule a home appointment, call: