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PHPSHORTBRAND is not available in this zip code, however, another plan may be, including our PPO plan: PHP Medicare Advantage (PPO). To find plans available for this zip code, click the link below, find your county on the map, and enter your zip code.
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PHPSHORTBRAND is not available in this zip code, however, another plan may be, including our PPO plan: PHP Medicare Advantage (PPO). To find plans available for this zip code, click the link below, find your county on the map, and enter your zip code.
View Plan Map
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
PHPSHORTBRAND is not available in this zip code, however, another plan may be, including our PPO plan: PHP Medicare Advantage (PPO). To find plans available for this zip code, click the link below, find your county on the map, and enter your zip code.
View Plan Map
Thank you! Your submission has been received!
Oops! Something went wrong while submitting the form.
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2024 Plans Offered in Your Area

Jump to Important Plan Documents
PHPSHORTBRAND
PHPSHORTBRAND Plus
PHP Medicare Advantage (PPO)

Medical & Hospital

Monthly Premium

(No referrals for in-network specialist visits!)

$0

$0

$25

$25

$0

$0

Maximum Out-of-Pocket (MOOP)

(No referrals for in-network specialist visits!)

$3,600

$3,600

$3,600

$3,600

$5,500

$5,500

Annual Deductible

(No referrals for in-network specialist visits!)

No Medical or Rx Deductible

No Medical or Rx Deductible

No Medical or Rx Deductible

No Medical or Rx Deductible

No Medical or Rx Deductible

No Medical or Rx Deductible

Preventive Care/Screenings

(No referrals for in-network specialist visits!)

$0 Copay

$0 Copay

$0 Copay

$0 Copay

$0 Copay

$0 Copay

Primary Care Visits

(No referrals for in-network specialist visits!)

$0 Copay

$0 Copay

$0 Copay

$0 Copay

$0 Copay

$0 Copay

Specialist Visit

(No referrals for in-network specialist visits!)

$30 Copay

$30 Copay

$30 Copay

$30 Copay

$45 Copay

$45 Copay

Urgent Care

(No referrals for in-network specialist visits!)

$60 Copay

$60 Copay

$60 Copay

$60 Copay

$60 Copay

$60 Copay

Emergency Care

(No referrals for in-network specialist visits!)

$90 Copay

$90 Copay

$90 Copay

$90 Copay

$90 Copay

$90 Copay

Lab Services

(No referrals for in-network specialist visits!)

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

$10 Copay

Home Healthcare

(No referrals for in-network specialist visits!)

100% Coverage

100% Coverage

100% Coverage

100% Coverage

100% Coverage

100% Coverage

Chiropractic Care

(No referrals for in-network specialist visits!)

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

$20 Copay

Inpatient Hospital

(No referrals for in-network specialist visits!)

$200 Per Day for Days 1-7,
$0 Per Day for Day 8 and Beyond

$200 Per Day for Days 1-7,
$0 Per Day for Day 8 and Beyond

$200 Per Day for Days 1-7,
$0 Per Day for Day 8 and Beyond

$200 Per Day for Days 1-7,
$0 Per Day for Day 8 and Beyond

$350 Per Day for Days 1-5,
$0 Per Day for Day 6 and Beyond

$350 Per Day for Days 1-5,
$0 Per Day for Day 6 and Beyond

Outpatient Surgery at Hospital

(No referrals for in-network specialist visits!)

$150 Copay

$150 Copay

$150 Copay

$150 Copay

$200 Copay

$200 Copay

Outpatient Surgery at Ambulatory Surgery Center

(No referrals for in-network specialist visits!)

$100 Copay

$100 Copay

$100 Copay

$100 Copay

$150 Copay

$150 Copay

Extra Benefits

Vision Care By EyeMed

(No referrals for in-network specialist visits!)

$200 allowance per year

$400 allowance per year

$200 allowance per year

Dental Care By Delta Dental

(No referrals for in-network specialist visits!)

Preventive and Comprehensive services combined annual allowance $1,000

Preventive and Comprehensive services combined annual allowance $2,000

Preventive and Comprehensive services combined annual allowance $1,500

Over-the-Counter (OTC) Items

(No referrals for in-network specialist visits!)

$75 Per Quarter

$110 Per Quarter

$90 Per Quarter

Hearing By TruHearing

(No referrals for in-network specialist visits!)

$1,000 allowance for up to 2 hearing aids every 2 years (both ears combined)

$1,500 allowance for up to 2 hearing aids every 2 years (both ears combined)

$1,000 allowance for up to 2 hearing aids every 2 years (both ears combined)

Transportation Assistance

(No referrals for in-network specialist visits!)

$0 copay for 20 one-way trips to approved locations per year

$0 copay for 30 one-way trips to approved locations per year

$0 copay for 20 one-way trips to approved locations per year

SilverSneakers®

(No referrals for in-network specialist visits!)

Included at no additional cost

Included at no additional cost

Included at no additional cost

Travel Benefits

(No referrals for in-network specialist visits!)

Emergency or urgent care coverage if you are making a trip out of state or country

Emergency or urgent care coverage if you are making a trip out of state or country

Emergency or urgent care coverage if you are making a trip out of state or country

Post-Hospitalization Meal Benefit

(No referrals for in-network specialist visits!)

28 meals (2 meals/day for 14 days) delivered to the home after each discharge (limited to 2 discharges annually)

28 meals (2 meals/day for 14 days) delivered to the home after each discharge (limited to 2 discharges annually)

28 meals (2 meals/day for 14 days) delivered to the home after each discharge (limited to 2 discharges annually)

**Medicare-covered services are deemed to be medically necessary. These can include services and/or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms.

Part D Prescription Drug Coverage

Annual Deductible

(No referrals for in-network specialist visits!)

No Deductible

No Deductible

No Deductible

Tier 1 Preferred Generic

(No referrals for in-network specialist visits!)

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $5 Copay*

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $5 Copay*

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $5 Copay*

Tier 2 Non-Preferred Generics

(No referrals for in-network specialist visits!)

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $10 Copay*

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $10 Copay*

Preferred Pharmacies - $0 Copay*
Other Network Pharmacies - $20 Copay*

Tier 3 Preferred Brand Names

(No referrals for in-network specialist visits!)

Preferred Pharmacies - $40 Copay*
Other Network Pharmacies - $45 Copay*

Preferred Pharmacies - $40 Copay*
Other Network Pharmacies - $45 Copay*

Preferred Pharmacies - $42 Copay*
Other Network Pharmacies - $47 Copay*

Tier 4 Non-Preferred Brand Names

(No referrals for in-network specialist visits!)

Preferred Pharmacies - $90 Copay*
Other Network Pharmacies - $95 Copay*

Preferred Pharmacies - $90 Copay*
Other Network Pharmacies - $95 Copay*

Preferred Pharmacies - $95 Copay*
Other Network Pharmacies - $100 Copay*

Tier 5 Specialty Drugs

(No referrals for in-network specialist visits!)

Preferred & Other Network Pharmacies - 33% Co-insurance

Preferred & Other Network Pharmacies - 33% Co-insurance

Preferred & Other Network Pharmacies - 33% Co-insurance

Initial Coverage Limits

(No referrals for in-network specialist visits!)

$5,030 (Once the ICL is reached, the CMS mandated gap coverage applies, and member pays co-insurance of 25% for covered generics, 25% for covered brand)

$5,030 (Once the ICL is reached, the CMS mandated gap coverage applies, and member pays co-insurance of 25% for covered generics, 25% for covered brand)

$5,030 (Once the ICL is reached, the CMS mandated gap coverage applies, and member pays co-insurance of 25% for covered generics, 25% for covered brand)

What Medications Are Covered

View Covered Medications
View Covered Medications
* 30-Day Supply

Important Plan Documents

Select a document name to download.
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Updated:
9/18/2023
Annual Notice of Change
COMING SOON!
New to 2024
- New Plan -
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Updated:
9/22/2023
Evidence of Coverage
COMING SOON!
New to 2024
- New Plan -
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Updated:
3/19/2024
Prescription Drug Formulary
COMING SOON!
New to 2024
- New Plan -
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Updated:
4/3/2024
Provider Directory
COMING SOON!
New to 2024
- New Plan -
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Updated:
10/1/2023
Star Ratings
COMING SOON!
New to 2024
- New Plan -
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Updated:
9/12/2023
Summary of Benefits
COMING SOON!
New to 2024
- New Plan -
Formulary Change Notice
Formulary Change Notice
Updated:
2/20/2024
COMING SOON!
Formulary Change Notice
Formulary Change Notice
Updated:
2/20/2024
COMING SOON!
Formulary Change Notice
Updated:
2/20/2024
Formulary Change Notice
COMING SOON!
New to 2024
- New Plan -
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Updated:
10/1/2023
Low Income Subsidy Information
COMING SOON!
New to 2024
- New Plan -
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Updated:
9/18/2023
New to 2024
- New Plan -
Annual Notice of Change
COMING SOON!
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Updated:
9/22/2023
New to 2024
- New Plan -
Evidence of Coverage
COMING SOON!
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Updated:
3/19/2024
New to 2024
- New Plan -
Prescription Drug Formulary
COMING SOON!
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Updated:
4/3/2024
New to 2024
- New Plan -
Provider Directory
COMING SOON!
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Updated:
10/1/2023
New to 2024
- New Plan -
Star Ratings
COMING SOON!
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Updated:
9/12/2023
New to 2024
- New Plan -
Summary of Benefits
COMING SOON!
Formulary Change Notice
Formulary Change Notice
Updated:
COMING SOON!
Formulary Change Notice
Formulary Change Notice
Updated:
COMING SOON!
Formulary Change Notice
Updated:
New to 2024
- New Plan -
Formulary Change Notice
COMING SOON!
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Updated:
10/1/2023
New to 2024
- New Plan -
Low Income Subsidy Information
COMING SOON!
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Annual Notice of Change
Updated:
9/18/2023
COMING SOON!
Annual Notice of Change
Updated:
9/18/2023
New to 2024
- New Plan -
Annual Notice of Change
COMING SOON!
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Evidence of Coverage
Updated:
9/22/2023
COMING SOON!
Evidence of Coverage
Updated:
9/22/2023
New to 2024
- New Plan -
Evidence of Coverage
COMING SOON!
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Prescription Drug Formulary
Updated:
3/19/2024
COMING SOON!
Prescription Drug Formulary
Updated:
3/19/2024
New to 2024
- New Plan -
Prescription Drug Formulary
COMING SOON!
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Provider Directory
Updated:
4/3/2024
COMING SOON!
Provider Directory
Updated:
4/3/2024
New to 2024
- New Plan -
Provider Directory
COMING SOON!
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Star Ratings
Updated:
10/1/2023
COMING SOON!
Star Ratings
Updated:
10/1/2023
New to 2024
- New Plan -
Star Ratings
COMING SOON!
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Summary of Benefits
Updated:
9/12/2023
COMING SOON!
Summary of Benefits
Updated:
9/12/2023
New to 2024
- New Plan -
Summary of Benefits
COMING SOON!
Formulary Change Notice
Formulary Change Notice
Updated:
COMING SOON!
Formulary Change Notice
Formulary Change Notice
Updated:
COMING SOON!
Formulary Change Notice
Updated:
New to 2024
- New Plan -
Formulary Change Notice
COMING SOON!
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Low Income Subsidy Information
Updated:
10/1/2023
COMING SOON!
Low Income Subsidy Information
Updated:
10/1/2023
New to 2024
- New Plan -
Low Income Subsidy Information
COMING SOON!
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Call 844.908.0051 (TTY:711)*
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