Patient Advocate Foundation's Co-Pay Relief program exists to help reduce the financial distress patients, and their families face when paying for treatment. We believe that no patient should go without life changing medications because they cannot afford them. We are here to help. A copay (or copayment) is a flat fee that you pay on the spot each time you go to your doctor or fill a prescription. For example, if you hurt your back and go see your doctor, or you need a refill of your child's asthma medicine, the amount you pay for that visit or medicine is your copay. Home health care. $0 for home health care services. 20% of the Medicare-approved amount for Durable Medical Equipment (DME) Glossary. $0 for Hospice care. You may need to pay a Copayment of no more than $5 for each prescription drug and other similar products for pain relief and symptom control while you're at home. In the rare case your drug isn’t covered by the hospice. Out of Pocket Costs States can impose copayments, coinsurance, deductibles, and other similar charges on most Medicaid-covered benefits, both inpatient and outpatient services, and the amounts that can be charged vary with income. All out of pocket charges are based on. Medicare Advantage Plans Medicare Advantage plans include medical and dental. Some plans include prescription drug coverage. Our 2021 plans also have added benefits, such as in-home and virtual support & companionship, over-the-counter allowance, vision, hearing, acupuncture, wellness rewards, gym memberships and at-home fitness kits.
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801-893-6645 (TTY 711) orA few things to know before you begin your enrollment.Help is a phone call away. Please contact the Advantage U Enrollment Center at (801) 843-6645 (TTY 711) if you prefer to complete enrollment over the phone instead of online.Enrollment center hours are 8:00 a.m. to 8:00 p.m., Mountain Time, 7 days a week. If you are calling from April 1 through September 30, alternate technologies (for example, voicemail) will be used on weekends and holidays- The enrollment process should take about 15 minutes to complete. After your enrollment is processed, you will receive your plan materials along with a welcome call to answer any questions you might have.
- You will need your Medicare number to enroll. Before you get started you will want to make sure you have your Medicare card (the red, white and blue card) or your letter from the Social Security Administration handy.
- By completing this enrollment form you are sending an actual enrollment form to Advantage U. You will get an enrollment packet and a letter confirming your enrollment once your application has been approved by Medicare. Medicare beneficiaries may also enroll in the Advantage U Signature (PPO) plan through the Centers for Medicare and Medicaid Services (CMS) Medicare Plan finder at Medicare.gov/plan-compare.
- Once you submit your enrollment successfully, you will be provided with a confirmation number. Record this number for your reference until you receive your plan information in the mail.
CORONAVIRUS UPDATES AND COVERAGE DETAILS
Certified Medicare Specialist
During the national public health emergency period, Screening and/or testing for COVID-19 is covered in-network and out-of-network for a $0 copay.
Introducing Advantage U
With so many Medicare coverage options out there, it can be hard to know which plan to choose.
Thankfully, there’s a plan you can trust that was born right in our backyard. A new plan developed by Utahns with extensive health care experience and a dedication to providing Utahns like you with affordable coverage, benefits designed with you in mind and a network of doctors and hospitals you already know and trust. That plan is Advantage U.
Advantage U Signature (PPO) is available for Medicare beneficiaries in Davis, Salt Lake, Tooele, Utah, and Weber Counties.
Advantage U Signature (PPO) includes
Hospital and Medical Coverage
Advantage U offers the $0 Premium Advantage U Signature (PPO) plan. Fonepaw screen recorder.- $0 Monthly Premium (you must continue to pay your Part B Premium)
- $0 Copay for In-network Primary Care Physician (PCP)
- $30 Copay for In-network Specialist Visit
Prescription Drug Coverage
Our plan features a formulary (or drug list) with a broad number of prescription drugs on Tier 1 and Tier 2, so you can save more.See Summary of Benefits for additional prescription drug coverage information.Retail Cost-Sharing Tier 30-Day Supply 60-Day Supply 90-Day Supply Tier 1 (Preferred Generics) $3 copay $6 copay $0 copay Tier 2 (Generics) $10 copay $20 copay $20 copay Tier 3 (Preferred Brands) $47 copay $94 copay $141 copay Tier 4 (Non-Preferred Brands) $100 copay $200 copay $300 copay Tier 5 (Specialty Medications) 29% coinsurance Not offered Not Offered Senior Savings Model: For eligible insulins $35 copay for 30 days supply (eligible insulins not subject to Part D Deductible) This copay stays the same regardlesss of phase of benefit during the plan year.Dental
Our plan includes preventive dental coverage with a $0 copay and comprehensive dental coverage for fillings, extractions or adjunctive periodontal care. Up to $1,000 annual benefit for comprehensive coverage. Authorization rules apply.Storywriting. Ipanic. See Summary of Benefits for additional dental benefits.Vision
We offer a $0 copay for routine vision exam along with coverage for eyeglasses or contact lenses ($120 limit on eyeglasses and contacts).See Summary of Benefits for additional vision benefits.Hearing
Our plan includes a $0 copay for routine hearing exams through TruHearing along with hearing aid coverage.See Summary of Benefits for additional hearing benefits.Fitness
Enjoy a Fitness Center Membership to participating fitness centers and choose to receive Home Fitness Kits.You can visit a participating fitness center near you. You also have access to a variety of Home Fitness Kits. You can receive up to 2 Home Fitness Kits per benefit year.The Silver&Fit® program is provided by American Specialty Health Fitness, Inc., a subsidiary of American Specialty Health Incorporated (ASH). Silver&Fit® is a federally registered trademark of ASH and used with permission herein. Kits are subject to change. Participating facilities and fitness chains may vary by location and are subject to change.Over-the-Counter (OTC)
With our plan, members receive a $30 allowance each quarter to use for the purchase of select OTC products.
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Medicare Copay For Specialist
Documents and Notices
Plan Benefits and Coverage Details
Copay For Medicare Patients
Summary of Benefits |
Evidence of Coverage |
Provider Directory |
Pharmacy Directory |
Formulary |
Supplies for Diabetes |
Prescription Drug Transition Policy |
LIS Premium Summary Chart |
Medical Prior Authorization Form |
Advantage U Signature (PPO) Enrollment Form |
2021 Star Ratings |
Medical Claim Reimbursement Form |