We are pleased to announce that for 2013, AmeriHealth is introducing
AmeriHealth 65 Preferred HMO, an enhanced, affordably priced Medicare Advantage
HMO plan in New Jersey. Members receive all the benefits of Original Medicare,
plus many more, when they use providers in the AmeriHealth New Jersey provider
network. The plan is available to the Medicare-eligible population residing in
Burlington, Camden, Cumberland, Gloucester, and Salem Counties. The premium for
AmeriHealth 65 Preferred HMO is $24.30 for the medical-only plan, and $74.90
for the medical and prescription drug plan. The plan has a $6,700 out-of-pocket
maximum for 2013.
AmeriHealth 65 Preferred is an alternative to the AmeriHealth 65 NJ HMO plan,
which will be discontinued for individuals only, beginning January 1, 2013. In
addition to comprehensive medical coverage and vision, dental, and hearing
services, AmeriHealth 65 Preferred features an extensive provider network with
more than 3,000 primary care physicians, 50,000 specialist sites, and 100
hospitals, including Philadelphia-area providers.
Members receive access to the SilverSneakers
? Fitness Program;
preventive care; health resources and wellness programs; and support for
managing chronic conditions, such as asthma, diabetes, and chronic obstructive
pulmonary disease (COPD).
Medicare Part D prescription drug coverage is optional.
AmeriHealth 65 Preferred HMO benefit highlights
Service
Cost to member
Primary care physician visits
$15 copay per visit
Specialist visits
$35 copay per visit
Emergency department
$65 copay per visit (not waived if admitted)
Urgently needed care
$15 or $35 copay per visit
Outpatient surgery
$350 copay (per date of service) for outpatient Hospital; $100 copayfor
Ambulatory Surgical Centers (per date of service)
Inpatient hospital
$245 per day for days 1 ? 7 ($1,715 per stay maximum); unlimited
days per stay
Fitness program
SilverSneakers?
Preventive dental
$10 every six months exams and cleanings
Eyewear
$100 every 2 years ($65 frames, $35 lenses); $40 copay for eye exam every 2
years
Hearing aids and exams
Up to $500 for hearing aids (two aids) every 3 years; routine hearing exam ($40
every 3 years)
Please contact your Network Coordinator or Hospital/Ancillary Services
Coordinator if you have any questions.