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Zing Elite Select IL (HMO) - H7330-004-000

2.5 out of 5 stars* for plan year 2024

$0.00

Monthly Premium

Zing Elite Select IL (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Zing Health

Plan ID: H7330-004-000

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

$0.00

Monthly Premium

Illinois 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 Illinois 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$0.00
Vision coverage
Dental coverage
Hearing coverage
Prescription drugs
Medical deductible$0.00
Out-of-pocket maximum$2,900.00
Initial drug coverage limit$0.00
Catastrophic drug coverage limit$8,000.00
Primary care doctor visitIn-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0.00
Specialty doctor visitIn-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $15.00
Inpatient hospital careIn-Network:

Acute Hospital Services:
$275.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
Prior Authorization Required for Acute Hospital Services
Urgent care
Urgent Care:
Copayment for Urgent Care $0.00 to $10.00

Minimum for Urgent Care Services provided by a PCP. Maximum for Urgent Care Services provided by Other.

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $0.00
Maximum Plan Benefit of $100000.00
Emergency room visit
Emergency Care:
Copayment for Emergency Care $135.00
Copayment 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 transportationIn-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $175.00

Air Ambulance:
Coinsurance for Air Ambulance Services 20%

Please see Evidence of Coverage for Prior Authorization rules

Health Care Services and Medical Supplies

Zing Elite Select IL (HMO) covers a range of additional benefits. Learn more about Zing Elite Select IL (HMO) benefits, some of which may not be covered by Original Medicare (Part A and Part B).

CoverageDetails
Chiropractic servicesIn-Network:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $20.00
Diabetes supplies, training, nutrition therapy and monitoringIn-Network:

Diabetic Supplies and Services:
Coinsurance for Medicare-covered Diabetic Supplies 0% to 20%
Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 20%
Diabetic Supplies and Services limited to those from specified manufacturers(Please see Evidence of Coverage)
Durable medical equipment (DME)In-Network:

Durable Medical Equipment:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Prior Authorization Required for Durable Medical Equipment
This Plan has preferred Vendors/Manufacturers - Please see Evidence of Coverage
Diagnostic tests, lab and radiology services, and X-raysIn-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $0.00 to $25.00
Copayment for Medicare-covered Lab Services $0.00
Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $50.00 to $150.00
Coinsurance for Medicare-covered Therapeutic Radiological Services 20%
Copayment for Medicare-covered X-Ray Services $0.00
Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services
Home health careIn-Network:

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

Psychiatric Hospital Services:
$275.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
Prior Authorization Required for Psychiatric Hospital Services
Mental health outpatient careIn-Network:

Outpatient Mental Health Services:
Copayment for Medicare-covered Individual Sessions $15.00
Copayment for Medicare-covered Group Sessions $15.00
Prior Authorization Required for Outpatient Mental Health Services
Outpatient services/surgeryIn-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $250.00
Prior Authorization Required for Outpatient Hospital Services

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $150.00

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $150.00
Prior Authorization Required for Ambulatory Surgical Center Services
Outpatient substance abuse careIn-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $20.00
Copayment for Medicare-covered Group Sessions $20.00
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter itemsIn-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0.00
Maximum Plan Benefit of $175.00 every three months
Nicotine Replacement Therapy (NRT) offerred as a Part C OTC benefit
Podiatry servicesIn-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $15.00
Copayment for Routine Foot Care $15.00
  • Maximum 6 visits every year
Skilled Nursing Facility (SNF) careIn-Network:

Skilled Nursing Facility Services:
$0.00 per day for days 1 to 20
$203.00 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 $3000.00 every year 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 $3000.00 every year 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:
    Copayment for Medicare Covered Benefits $20.00
    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 $400.00 every year for all Non-Medicare covered eyewear

    Hearing Benefits

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

    CoverageDetails
    Hearing careIn-Network:

    Hearing Exams:
    Copayment for Medicare Covered Benefits $15.00
    Copayment for Routine Hearing Exams $0.00
    • Maximum 1 visit every year
    Copayment for Fitting/Evaluation for Hearing Aid $0.00
    • Maximum 1 visit every three years

    Hearing Aids:
    Copayment for Hearing Aids - Inner Ear $0.00
    • Maximum 2 Hearing Aids - Inner Ear every three years
    Copayment for Hearing Aids - Outer Ear $0.00
    • Maximum 2 Hearing Aids - Outer Ear every three years
    Copayment for Hearing Aids - Over the Ear $0.00
    • Maximum 2 Hearing Aids - Over the Ear every three years
    Maximum Plan Benefit of $750.00 every three years per ear
    Members are provided: ?Three follow-up visits ?3-year repair warranty ?3 years of batteries included ?One-time replacement coverage for lost, stolen or damaged hearing aids -In the event a Hearing Aid is lost stolen or damaged, the member pays a deductible ($175-$225) depending on the specific manufacturer of the hearing aid in question.

    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 programsIn-Network:
    $0.00 copay for Medicare Covered Preventive Services:

    Abdominal aortic aneurysm screening
    Alcohol misuse screenings & counseling
    Bone mass measurements (bone density)
    Cardiovascular disease screenings
    Cardiovascular disease (behavioral therapy)
    Cervical & vaginal cancer screening
    Colorectal cancer screenings
    Depression screenings
    Diabetes screenings
    Diabetes self-management training
    Glaucoma tests
    Hepatitis B (HBV) infection screening
    Hepatitis C screening test
    HIV screening
    Lung cancer screening
    Mammograms (screening)
    Nutrition therapy services
    Obesity screenings & counseling
    One-time Welcome to Medicare preventive visit
    Prostate cancer screenings(PSA)
    Sexually transmitted infections screening & counseling
    Shots:
    • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation
    Yearly "Wellness" visit

    When reviewing Illinois 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 Illinois 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

    Illinois 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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