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Zing Choice Diabetes & Heart Complete TN (PPO C-SNP) - H9618-009-000

na* for plan year 2024

$41.40

Monthly Premium

Zing Choice Diabetes & Heart Complete TN (PPO C-SNP) is a PPO C-SNP Medicare Advantage (Medicare Part C) plan offered by Zing Health

Plan ID: H9618-009-000

* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.

$41.40

Monthly Premium

Tennessee Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.

Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.

Learn more about Tennessee Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.

Basic Costs and Coverage

CoverageDetails
Monthly plan premium$41.40
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$545.00
Out-of-pocket maximum$8,850.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visitIn-Network:

Doctor Office Visit:
Coinsurance for Primary Care Office Visit 20%
Specialty doctor visitIn-Network:

Doctor Specialty Visit:
Coinsurance for Physician Specialist Office Visit 20%
Inpatient hospital care
Out-of-Network:
Copayment for Acute Hospital Services per Stay $0.00
Copayment for Acute Hospital Services $0.00
Urgent care
Urgent Care:
Coinsurance for Urgent Care 20%

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0.00
Maximum Plan Benefit of $100000.00
Emergency room visit
Emergency Care:
Coinsurance for Emergency Care 20%
Coinsurance for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $0.00
Maximum Plan Benefit of $100000.00
Ambulance transportation
Out-of-Network:

Ambulance Services:
Coinsurance for Medicare Covered Ambulance Services - Ground 20%
Coinsurance for Medicare Covered Ambulance Services - Air 20%

Health Care Services and Medical Supplies

Zing Choice Diabetes & Heart Complete TN (PPO C-SNP) covers a range of additional benefits. Learn more about Zing Choice Diabetes & Heart Complete TN (PPO C-SNP) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic services
Out-of-Network:

Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 20%
Diabetes supplies, training, nutrition therapy and monitoring
Out-of-Network:

Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies and Services 20%
Durable medical equipment (DME)
Out-of-Network:

Durable Medical Equipment:
Coinsurance for Medicare Covered Durable Medical Equipment 20%
Diagnostic tests, lab and radiology services, and X-rays
Out-of-Network:

Outpatient Diag Procs/Tests/Lab Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests 20%
Coinsurance for Medicare Covered Lab Services 20%
Coinsurance for Medicare Covered Diagnostic Radiological Services 20%
Coinsurance for Medicare Covered Therapeutic Radiological Services 20%
Coinsurance for Medicare Covered Outpatient X-Ray Services 20%
Home health careIn-Network:

Home Health Services:
Copayment for Medicare-covered Home Health Services $0.00
Mental health inpatient careIn-Network:

Psychiatric Hospital Services:
$0.00 per day for days 1 to 60
$400.00 per day for days 61 to 90
Deductible $1364.00
Prior Authorization Required for Psychiatric Hospital Services
Mental health outpatient careIn-Network:

Outpatient Mental Health Services:
Coinsurance for Medicare-covered Individual Sessions 20%
Coinsurance for Medicare-covered Group Sessions 20%
Prior Authorization Required for Outpatient Mental Health Services
Outpatient services/surgery
Out-of-Network:

Outpatient Hospital and ASC Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 20%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 20%
Outpatient substance abuse care
Out-of-Network:

Outpatient Substance Abuse Services:
Coinsurance for Medicare Covered Individual or Group Sessions 20%
Over-the-counter itemsIn-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0.00
Maximum Plan Benefit of $195.00 every month
Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit
Podiatry servicesIn-Network:

Podiatry Services:
Coinsurance for Medicare-Covered Podiatry Services 20%
Copayment for Routine Foot Care $0.00
  • Maximum 12 visits every year
Skilled Nursing Facility (SNF) careIn-Network:

Skilled Nursing Facility Services:
$0.00 per day for days 1 to 20
$200.00 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services

Dental Benefits

The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

CoverageDetails
Dental careIn-Network:

Preventive Dental:
Copayment for Office Visit $0.00
Office Vists include:
    • Maximum 1 visit every six months
    Copayment for Oral Exams $0.00
    • Maximum 1 visit every six months
    Copayment for Prophylaxis (Cleaning) $0.00
    • Maximum 1 visit every six months
    Copayment for Fluoride Treatment $0.00
    • Maximum 1 visit every year
    Copayment for Dental X-Rays $0.00
    • Maximum 1 visit every year
    Maximum Plan Benefit of $3500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined

    Comprehensive Dental:
    Copayment for Medicare-covered Benefits $0.00
    Copayment for Non-routine Services $0.00
    Copayment for Diagnostic Services $0.00
    Copayment for Restorative Services $0.00
    Copayment for Endodontics $0.00
    Copayment for Periodontics $0.00
    Copayment for Extractions $0.00
    • Maximum 1 visit every year
    Copayment for Prosthodontics, Other Oral/Maxillofacial Surgery, Other Services $0.00
    Maximum Plan Benefit of $3500.00 every year for in and out of network services combined for Preventive and Non-Medicare Covered Comprehensive combined
    Prior Authorization Required for Comprehensive Dental

    Vision Benefits

    The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage

    CoverageDetails
    Vision careIn-Network:

    Eye Exams:
    Coinsurance for Medicare Covered Benefits 20%
    Copayment for Routine Eye Exams $0.00
    • Maximum 1 Routine Eye Exam every year

    Eyewear:
    Copayment for Medicare-Covered Benefits $0.00
    Copayment for Contact Lenses $0.00
    • Maximum 1 Pair every year
    Copayment for Eyeglasses (lenses and frames) $0.00
    • Maximum 1 Pair every year
    Copayment for Eyeglass Lenses $0.00
    • Maximum 1 Pair every year
    Copayment for Eyeglass Frames $0.00
    • Maximum 1 Pair every year
    Maximum Plan Benefit of $325.00 every year for all Non-Medicare covered eyewear for in and out of network services combined

    Hearing Benefits

    The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

    CoverageDetails
    Hearing care
    Out-of-Network:

    Medicare Covered Hearing Services:
    Coinsurance for Medicare Covered Hearing Exams 20%
    Non-Medicare Covered Hearing Services:
    Coinsurance for Non-Medicare Covered Hearing Exams 50%
    Coinsurance for Non-Medicare Covered Hearing Aids 50%

    Preventive Services and Health/Wellness Education Programs

    The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.

    CoverageDetails
    Preventive services and health/wellness education programs
    Out-of-Network:

    Medicare-covered Zero Dollar Preventive Services:
    Copayment for Medicare Covered Medicare-covered Preventive Services $0.00

    Prescription Drug Costs and Coverage

    The Zing Choice Diabetes & Heart Complete TN (PPO C-SNP) offers prescription drug coverage, with an annual drug deductible of $545.00 (excludes Tiers 1 and 6)

    Coverage & Cost
    Coverage
    Cost
    Annual drug deductible$545.00 (excludes Tiers 1 and 6)
    Tier 1
    • Standard retail $0.00
    • Standard mail order $0.00
    Tier 6
    • Standard retail $0.00
    • Standard mail order $0.00
    Annual drug deductible$545.00 (excludes Tiers 1 and 6)
    Tier 1
    • Standard retail $0.00
    • Standard mail order $0.00
    Tier 6
    • Standard retail $0.00
    • Standard mail order $0.00
    Annual drug deductible$545.00 (excludes Tiers 1 and 6)
    Tier 1
    • Standard retail $0.00
    • Standard mail order $0.00
    Tier 6
    • Standard retail $0.00
    • Standard mail order $0.00

    When reviewing Tennessee Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.

    You may be able to find plans in your part of Tennessee that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.

    Plan Documents

    Links to plan documents

    Tennessee Counties Served

    We represent carriers such as Humana, UnitedHealthcare®, Anthem Blue Cross and Blue Shield*, Aetna, Cigna Healthcare, Wellcare, or Kaiser Permanente.

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