- Part D included
- Primary care covered at 100%
- Suplemental Benefits for vision, hearing and dental are as follows:
- VISION
- 20% coinsurance for one routine eye exam per year
- 20% coinsurance for 12 pairs of contacts per year and/or 1 pair of glasses with $100 maximum benefit
- HEARING
- 20% coinsurance for one routine hearing exam per year
- 20% coinsurance for 1 hearing aid per year with [$750] maximum benefit
- DENTAL
- 20% coinsurance for an office visit that includes:
- - 1 oral exam every 6 months
- - 1 cleaning every 6 months
- $100 maximum benefit for preventative dental every 6 months
- 20% coinsurance for 1 dental x-ray per year with $50 maximum benefit
- 20% coinsurance for dental fillings and extractions with $275 maximum benefit per year
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AAA4 Traditional Plan (HMO)
Premium: $36.10/mo.
Premium: $36.10/mo.
