MedicareCommons™

Neutral. Transparent. Retrieval-first.

🩺 Doctor’s Office Visits
Service 2026 2025
PrimaryComing soon% - % Coinsurance
SpecialistComing soon$15.00 Copay
Prior Authorization Required
🏥 Emergency, Urgent, and Inpatient Hospital Coverage
Service 2026 2025
Emergency room careComing soon$375.00 Copay
Prior Authorization Required
Urgent careComing soon$35.00 Copay
Prior Authorization Required
Ground ambulanceComing soon$255.00 Copay
Prior Authorization Required
Inpatient hospital careComing soon$250.00 (days 1–6), $0.00 (days 7–90)
Prior Authorization Required
Skilled Nursing FacilityComing soon$0.00 (days 1–20), $203.00 (days 21–100)
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% Coinsurance
Prior Authorization Required
Routine chiropracticComing soon20% Coinsurance
Prior Authorization Required
🧠 Mental Health Services
Service 2026 2025
Outpatient individual therapyComing soon$0.00 Copay
Outpatient group therapyComing soon% - % Coinsurance
Inpatient psychiatric hospital careComing soon$250.00 (days 1–6), $0.00 (days 7–90)
Prior Authorization Required
🏋️ Rehabilitation Services
Service 2026 2025
Physical therapy and speech/language therapyComing soon$35.00 Copay
Occupational therapyComing soon$35.00 Copay
Prior Authorization Required
🧰 Medical Equipment and Supplies
Service 2026 2025
Diabetes suppliesComing soon% - % Coinsurance
Prior Authorization Required
Durable medical equipmentComing soon$35.00 Copay
6 visits/yr
ProstheticsComing soon$0.00 - $35.00 Copay
🔬 Diagnostics, Lab Services, and Imaging
Service 2026 2025
Diagnostic radiology servicesComing soon$35.00 Copay
Prior Authorization Required
Lab servicesComing soon$35.00 Copay
Prior Authorization Required
Outpatient x-raysComing soon$0.00 - $35.00 Copay
Diagnostic tests and proceduresComing soon$35.00 Copay
💉 Medicare Part B Drugs
Service 2026 2025
ChemotherapyComing soon0% - 20% Coinsurance
Prior Authorization Required
Other Part B drugs (Medicare-covered)Coming soon20% Coinsurance
Prior Authorization Required

Supplemental Benefits

🦷 Dental Services
Service 2026 2025
Medicare Covered Preventive DentalComing soonNot Covered
Oral examComing soon% - % Coinsurance
Dental x-raysComing soon% - % Coinsurance
CleaningComing soon% - % Coinsurance
PeriodonticsComing soon$0.00 Copay
EndodonticsComing soon$0.00 Copay
Restorative ServicesComing soon$0.00 Copay
Dental MaximumComing soonNot Covered
👂 Hearing Aids and Services
Service 2026 2025
Fitting/evaluationComing soon% - % Coinsurance
Hearing aidsComing soon% - % Coinsurance
Hearing examComing soonNot Covered
Hearing MaximumComing soonNot Covered
👓 Vision Services
Service 2026 2025
Medicare-covered eye examComing soonNot Covered
Routine eye examComing soon% - % Coinsurance
Eyewear benefitsComing soon% - % Coinsurance
Vision Eyewear MaximumComing soonNot Covered
{listing_template_3} {listing_template_4}

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
Tier 130-day: —
90-day: —		30-day: —
90-day: —
Tier 230-day: —
90-day: —		30-day: —
90-day: —
Tier 330-day: —
90-day: —		30-day: —
90-day: —
Tier 430-day: —
90-day: —		30-day: —
90-day: —
Tier 530-day: —
90-day: —		30-day: —
90-day: —
*Deductible does not apply.