This booklet gives you the details about your Medicare health care and prescription drug coverage from January 1, 2021 – December 31, 2021. It explains how to get coverage for the health care services and prescription drugs you need. This is an important legal document.
This is a summary of drug and health services covered by Banner Medicare Advantage from January 1, 2021 to December 31, 2021. The benefit information provided is a summary of what we cover and what you pay. It does not list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, see the “Evidence of Coverage.” This information is not a complete description of benefits. Limitations, co-payments, and restrictions may apply.
Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium. The monthly Part B premium is paid for by State in some cases. Your cost-sharing is determined by your level of Medicaid eligibility. Premium, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact our Customer Care Center for further details.