MedicareCommons™

Neutral. Transparent. Retrieval-first.

🩺 Doctor’s Office Visits
Service 2026 2025
PrimaryComing soon20% - 20% Coinsurance
SpecialistComing soon20% - 20% Coinsurance
Prior Authorization Required
🏥 Emergency, Urgent, and Inpatient Hospital Coverage
Service 2026 2025
Emergency room careComing soon20% Coinsurance
Prior Authorization Required
Urgent careComing soon20% - 20% Coinsurance
Prior Authorization Required
Ground ambulanceComing soon0% - 20% Coinsurance
Prior Authorization Required
Inpatient hospital careComing soon$0.00 (days –), $0.00 (days –), $0.00 (days –)
Prior Authorization Required
Skilled Nursing FacilityComing soon$0.00 (days –), $0.00 (days –), $0.00 (days –)
Prior Authorization Required
🦶 Foot Care
Service 2026 2025
Foot Exams and Treatments (Medicare-covered)Coming soon20% Coinsurance
Routine Foot CareComing soon0% - 20% Coinsurance
Prior Authorization Required
💆 Chiropractic Care
Service 2026 2025
Medicare-covered chiropracticComing soon20% - 20% Coinsurance
Prior Authorization Required
Routine chiropracticComing soon20% - 20% Coinsurance
Prior Authorization Required
🧠 Mental Health Services
Service 2026 2025
Outpatient individual therapyComing soon20% Coinsurance
Outpatient group therapyComing soon20% Coinsurance
Inpatient psychiatric hospital careComing soon$0.00 (days –), $0.00 (days –), $0.00 (days –)
Prior Authorization Required
🏋️ Rehabilitation Services
Service 2026 2025
Physical therapy and speech/language therapyComing soon20% - 20% Coinsurance
Occupational therapyComing soon20% - 20% Coinsurance
🧰 Medical Equipment and Supplies
Service 2026 2025
Diabetes suppliesComing soonNot Covered
Prior Authorization Required
Durable medical equipmentComing soon20% - 20% Coinsurance
ProstheticsComing soon20% - 20% Coinsurance
🔬 Diagnostics, Lab Services, and Imaging
Service 2026 2025
Diagnostic radiology servicesComing soon20% - 20% Coinsurance
Lab servicesComing soon20% - 20% Coinsurance
Prior Authorization Required
Outpatient x-raysComing soon0% - 20% Coinsurance
Diagnostic tests and proceduresComing soon20% - 20% Coinsurance
💉 Medicare Part B Drugs
Service 2026 2025
ChemotherapyComing soon0% - 20% Coinsurance
Prior Authorization Required
Other Part B drugs (Medicare-covered)Coming soon20% Coinsurance

Supplemental Benefits

🦷 Dental Services
Service 2026 2025
Medicare Covered Preventive DentalComing soon$0.00 max
$0.00 max
Oral examComing soonNot Covered
Dental x-raysComing soonNot Covered
CleaningComing soonNot Covered
PeriodonticsComing soon50% Coinsurance
EndodonticsComing soon50% Coinsurance
Restorative ServicesComing soon50% Coinsurance
Dental MaximumComing soonNot Covered
👂 Hearing Aids and Services
Service 2026 2025
Fitting/evaluationComing soonNot Covered
Hearing aidsComing soon$690.00 - $1,890.00 Copay
Hearing examComing soon$0.00 max
$0.00 max
Hearing MaximumComing soon$0.00 max
👓 Vision Services
Service 2026 2025
Medicare-covered eye examComing soon$0.00 max
$0.00 max
Routine eye examComing soonNot Covered
Eyewear benefitsComing soonNot Covered
Vision Eyewear MaximumComing soon$300.00/yr eyewear
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Part D Plan Premium

The Part D prescription drug plan premium is included in your overall Medicare Advantage plan cost. However, additional expenses or subsidies may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help. LIS, provided by Social Security, helps those with limited income and resources to lower or eliminate Part D costs. LIS benefits are not part of Medicare Advantage coverage.

{name} Prescription Drug Plan Premium Details
Basic Part D Premium: ${part_d_basic_premium}
Supplemental Part D Premium: ${part_d_supplemental_premium}
Total Part D Premium: ${part_d_total_premium}
Low-Income Premium Subsidy: ${part_d_lips_amount}
Low-Income Premium Subsidy Paid by CMS: ${part_d_lips_cms_pays}
Low-Income Subsidy Premium: ${part_d_lis_premium}

For more details, visit the Social Security Extra Help program.

Prescription Drug Plan Deductible

This plan has a ${deductible} annual Part D deductible. You'll pay this deductible at the pharmacy before {carrier} starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, {name} may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

{name} Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
*Deductible does not apply.