updates

summary-of-benefits-paragraphs.txt

@@ -184,63 +184,33 @@ For generic drugs,  for a 30-day supply, you  pay a $0 copay and for a 90-day su
 For brand name drugs that happen to be treated as generic drugs, you pay a $1.45 copay for a 30-day supply and for a 90-day supply you pay a $1.45 copay or you can also just pay 15% of the cost.
 Note that some drugs are only limited to a 30-day supply.
 
-ADDITIONAL DRUG COVERAGE 
-Erectile dysfunction (ED) 
-drugs 
-Covered at Tier 1 cost-share amount. 
-Anti-Obesity drugs Covered at Tier 2 cost-share amount. 
-Prescription Vitamins Covered at Tier 1 cost-share amount. 
-Cost sharing may change depending on the pharmacy you choose, when you enter another phase of the 
-Part D benefit and if you qualify for "Extra Help." To find out if you qualify for "Extra Help," please contact 
-the Social Security Office at 1-800-772-1213 Monday — Friday, 7 a.m. — 7 p.m. TTY users should call 
-1-800-325-0778. For more information on your prescription drug benefit, please call us or access your 
-"Evidence of Coverage" online. 
-If you reside in a long-term care facility, you pay the same as at a retail pharmacy. 
-You may get drugs from an out-of-network pharmacy but may pay more than you pay at an in-network 
-pharmacy. 
-
-Coverage Gap 
-After you enter the coverage gap, you pay 25 percent of the plan's cost for covered brand name drugs 
-and 25 percent of the plan's cost for covered generic drugs until your out-of-pocket costs total $7,400 — which is the end of the coverage gap. Not everyone will enter the coverage gap. 
-Under this plan, you may pay even less for the following: 
-Tier 1 (Preferred Generic) - All Drugs 
-Tier 2 (Generic) - All Drugs 
-Tier 3 (Preferred Brand) - Select Insulin Drugs 
-For more information on cost sharing in the coverage gap, please call us or access your Evidence of 
-Coverage online. 
-
-Catastrophic Coverage 
-After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and 
-through mail order) reach $7,4 00 you pay the greater of: 
-• 5% of the cost, or 
-• $4.15 copay for generic (including brand drugs treated as generic) and a $10.35 copay for all other 
-drugs 
-
-Additional Benefits 
-Medicare-covered foot care 
-(podiatry) 
-$15 copay 
-Medicare-covered chiropractic 
-services 
-$20 copay 
-Medical equipment/ supplies 
-Cost share may vary depending 
-on the service and where service 
-is provided 
-• Durable medical equipment (like wheelchairs or oxygen): 16% of 
-the cost 
-• Medical supplies: 20% of the cost 
-• Prosthetics (artificial limbs or braces): 20% of the cost 
-• Diabetic monitoring supplies: $0 copay or 10% to 20% of the cost 
-Rehabilitation services • Occupational and speech therapy: $15 copay 
-• Cardiac rehabilitation: $10 copay 
-• Pulmonary rehabilitation: $10 copay 
-Telehealth services 
-(in addition to Original 
-Medicare) 
-• Primary care provider (PCP): $0 copay 
-• Specialist: $15 copay 
-• Urgent care services: $0 copay 
+In addition, Erectile dysfunction (ED) drugs are covered at the Tier 1 cost-share amount. 
+Anti-Obesity drugs are Covered at the Tier 2 cost-share amount.  Prescription Vitamins are Covered at the Tier 1 cost-share amount. 
+Cost sharing may change depending on the pharmacy you choose, when you enter another phase of the Part D benefit and if you qualify for "Extra Help." To find out if you qualify for "Extra Help," please contact the Social Security Office at 1-800-772-1213 Monday — Friday, 7 a.m. — 7 p.m. TTY users should call 1-800-325-0778. For more information on your prescription drug benefit, please call us or access your "Evidence of Coverage" online. 
+If you reside in a long-term care facility, you pay the same as at a retail pharmacy.  You may get drugs from an out-of-network pharmacy but may pay more than you pay at an in-network pharmacy. 
+
+After you enter the coverage gap, you pay 25 percent of the plan's cost for covered brand name drugs and 25 percent of the plan's cost for covered generic drugs until your out-of-pocket costs total $7,400 — which is the end of the coverage gap. Not everyone will enter the coverage gap. 
+Under this plan, you may pay even less for the following, all Tier 1 (Preferred Generic) Drugs , all Tier 2 (Generic) drugs and for select insulin tier 3 preferred brand drugs.  For more information on cost sharing in the coverage gap, please call us or access your Evidence of Coverage online. 
+
+For Catastrophic Coverage , after your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,4 00 you pay the greater of  5% of the cost, or  $4.15 copay for generic (including brand drugs treated as generic) and a $10.35 copay for all other drugs .
+
+Medicare-covered foot care (podiatry) has a $15 copay .
+
+Medicare-covered chiropractic services has a $20 copay .
+
+Medical equipment/ supplies cost share may vary depending on the service and where service is provided . 
+Forf Durable medical equipment (like wheelchairs or oxygen) you pay 16% of the cost . 
+For Medical supplies you pay 20% of the cost .
+For  Prosthetics (such as artificial limbs or braces) you pay  20% of the cost .
+For  Diabetic monitoring supplies you pay a $0 copay or 10% to 20% of the cost .
+
+For Rehabilitation services such as  Occupational and speech therapy you pay a $15 copay .
+For Rehabilitation services such as Cardiac rehabilitation there is a $10 copay .
+For Rehabilitation services such as Pulmonary rehabilitation there is a  $10 copay .
+
+For Telehealth services (in addition to Original Medicare) for the  Primary care provider (PCP) there is a $0 copay .
+For Telehealth services (in addition to Original Medicare) for Specialist there is a  $15 copay .
+For Telehealth services (in addition to Original Medicare) for  Urgent care services there is a  $0 copay .
 • Substance abuse and behavioral health services: $0 copay