LiveWell Benefits

  • $19 monthly plan premium (LIS applies)

  • $275 Part D deductible (Drugs in Tier 1 and Tier 2 are excluded from the deductible)

  • Medicare Prescription Drug Coverage (Part D)

    Copays: Tier 1–$3, Tier 2–$12, Tier 3–$47, Tier 4–$100, Tier 5–27% coinsurance

  • $15 copay Primary Care visits

  • $35 copay Specialist visits

  • $25 copay Physical Therapy
  • Optional benefit $9 monthly premium for $0 annual  eye exam. Our plan pays up to $275 every year for eyeglasses

  • $0 for Annual hearing exam- Our plan pays up to $1,000 every 2 years for hearing aids

  • Optional $16 Dental monthly premium—Preventive & Comprehensive Services (No cap)

  • $10 copay Acupuncture – 10 treatments per year

  • $20 copay Chiropractor

  • SilverSneakers Wellness/Fitness Program

  • Rewards & Incentive Program

  • LiveWell Navigator to help you access all your health benefits

For more information about covered  services associated and cost-sharing (e.g., co-payments, co-insurance and  deductibles) including any conditions  and limitations please refer to the 2019 LiveWell Summary of Benefits