2023 Plan Comparison

Super Plus & Super Complete

For those with cardiovascular disorders, chronic heart failure, and/or diabetes. Super Plus is designed for Medicare members and Super Complete is designed for members with Medicare and Medicaid.

Dialysis Plus & Dialysis Complete

For those with End-Stage Renal Disease (ESRD) requiring any mode of dialysis. Dialysis Plus is designed for Medicare members and Dialysis Complete is designed for members with Medicare and Medicaid.

Honest Care

For those without chronic conditions who are seeking a plan with extra benefits and the flexibility to see the doctor of their choice with no referral required.

Why Choose a Gold Kidney Health Plan?

Members have the flexibility to choose their own provider without paying more. All services have the same cost regardless of if the provider of choice is in or out of network. No referrals are needed, and few prior authorizations are required. Gold Kidney removes barriers and empowers physician partners to direct patient care for a better quality of life.

2023 Summary of Benefits

Benefits Beyond Medicare

Full Plan Comparison

Super Plus & Super Complete  

MEMBER VALUE ADDED ITEMS
Part B Premium Reduction (Buydown or Money back in their Social Security check)
MEMBER COST SHARES
Plan Premium
Maximum out-of-pocket - MOOP
Primary Care Physician - PCP
Specialist (Nephrologist, Cardiologist, Endocrinologist, and Cardiovascular surgeons)
Specialist (all other)
Urgent Care
Emergency
Inpatient Hospital
Outpatient Hospital
Outpatient ASC
Tests (Diagnostic Radiology)
Lab Services
Dialysis
EXTRAS INCLUDED
Dental
Transportation
Over-the-Counter
Fitness
Companion Care
Prescription Drugs - 30-day supply at retail (Varies by Tier Level or Coverage Stage)
Senior Savings Participation
Original Medicare Fee-For-Service
N/A
N/A
N/A
20%
20%
20%
20%
20%
$1,556 deductible per benefit period
$0 for the first 60 days of each benefit period
$389 per day for days 61–90 of each benefit period
20%
20%
20%
20%
20%
Routine dental not covered
Non-emergency transportation one-way not covered**
Not covered
Not covered
Not covered
Not covered
Not covered
Super Plus HMO C-SNP
$25.00
$0
$3,000
$0
$0
$20
$0
$90
$100 for Days 1-7
$0 for diagnostic colonoscopy
$195 per day for all other services
$100 per visit
$50
$0
20%
Preventive & Comprehensive Services
$2,000 benefit coverage amount per year
$0 for 36 one-way trips per year
$50 quarterly allowance
$0 for Silver & Fit gym membership
$0 for home-based care visits
$0 | $5 | $45 | $100 | 33% | $0
Yes
Super Complete HMO C-SNP
$0
MEDICARE+MEDICAID / MEDICARE ONLY
$0 / $42.60
$8,300
0% / 20%
0% / 20%
0% / 20%
$0 / $60
$0 / $95
$0 / Medicare cost shares
0% / 20%
0% / 20%
0% / 20%
$0
0% / 20%
Preventive & Comprehensive Services
$4,000 benefit coverage amount per year
$0 for 54 one-way trips per year
$400 quarterly allowance
$0 for Silver & Fit gym membership
$0 for home-based care visits
$0 - $10.35 / 25% | 15%
No

Dialysis Plus & Dialysis Complete 

MEMBER VALUE ADDED ITEMS
Part B Premium Reduction (Buydown or Money back in their Social Security check)
MEMBER COST SHARES
Plan Premium
Maximum out-of-pocket - MOOP
Primary Care Physician - PCP
Specialist (Nephrologist, Cardiologist, Endocrinologist, and Cardiovascular surgeons)
Specialist (all other)
Urgent Care
Emergency
Inpatient Hospital
Outpatient Hospital
Outpatient ASC
Tests (Diagnostic Radiology)
Lab Services
Dialysis
EXTRAS INCLUDED
Dental
Transportation
Over-the-Counter
Fitness
Companion Care
Prescription Drugs - 30-day supply at retail (Varies by Tier Level or Coverage Stage)
Senior Savings Participation
Original Medicare Fee-For-Service
N/A
N/A
N/A
20%
20%
20%
20%
20%
$1,556 deductible per benefit period
$0 for the first 60 days of each benefit period
$389 per day for days 61–90 of each benefit period
20%
20%
20%
20%
20%
Routine dental not covered
Non-emergency transportation one-way not covered**
Not covered
Not covered
Not covered
Not covered
Not covered
Dialysis Plus HMO-POS C-SNP
$0
$0
$2,700
$0
$0
$20
$40
$120
$175 for Days 1-7
$0 for diagnostic colonoscopy
$195 per day for all other services
$100 per visit
$50
$0
20%
Preventive & Comprehensive Services
$2,000 benefit coverage amount per year
$0 for 104 one-way trips per year
$50 quarterly allowance
$0 for Silver & Fit gym membership
$0 for home-based care visits
$0 | $5 | $45 | $100 | 33% | $0
Yes
Dialysis Complete HMO-POS C-SNP
$0
MEDICARE+MEDICAID / MEDICARE ONLY
$0 / $42.60
$8,300
0% / 20%
0% / 20%
0% / 20%
$0 / $60
$0 / $95
$0 / Medicare cost shares
0% / 20%
0% / 20%
0% / 20%
0% / 20%
0% / 20%
Preventive & Comprehensive Services
$4,000 benefit coverage amount per year
$0 for 104 one-way trips per year
$400 quarterly allowance
$0 for Silver & Fit gym membership
$0 for home-based care visits
$25% | Greater than 5% of $4.15 | $10.35
No

Honest Care

MEMBER VALUE ADDED ITEMS
Part B Premium Reduction (Buydown or Money back in their Social Security check)
MEMBER COST SHARES
Plan Premium
Maximum out-of-pocket - MOOP
Primary Care Physician - PCP
Specialist (Nephrologist, Cardiologist, Endocrinologist, and Cardiovascular surgeons)
Specialist (all other)
Urgent Care
Emergency
Inpatient Hospital
Outpatient Hospital
Outpatient ASC
Tests (Diagnostic Radiology)
Lab Services
Dialysis
EXTRAS INCLUDED
Dental
Transportation
Over-the-Counter
Fitness
Companion Care
Prescription Drugs - 30-day supply at retail (Varies by Tier Level or Coverage Stage)
Senior Savings Participation
Original Medicare Fee-For-Service
N/A
N/A
N/A
20%
20%
20%
20%
20%
$1,556 deductible per benefit period
$0 for the first 60 days of each benefit period
$389 per day for days 61–90 of each benefit period
20%
20%
20%
20%
20%
Routine dental not covered
Non-emergency transportation one-way not covered**
Not covered
Not covered
Not covered
Not covered
Not covered
Honest Care HMO
$25.00
$0
$3,000
$0
$20
$20
$20
$90
$175 for Days 1-7
$0 for diagnostic colonoscopy
$225 per day for all other services
$150 per visit
$50
$0
20%
Preventive & Comprehensive Services
$2,000 benefit coverage amount per year
$0 for 24 one-way trips per year
$50 quarterly allowance
$0 for Silver & Fit gym membership
$0 for home-based care visits
$0 | $5 | $45 | $100 | 33% | $0
Yes

2023 Summary of Benefits

Super Plus & Super Complete

For those with cardiovascular disorders, chronic heart failure, and/or diabetes. Super Plus is designed for Medicare members and Super Complete is designed for members with Medicare and Medicaid.

English

Spanish

Dialysis Plus & Dialysis Complete

For those with End-Stage Renal Disease (ESRD) requiring any mode of dialysis. Dialysis Plus is designed for Medicare members and Dialysis Complete is designed for members with Medicare and Medicaid.

English

Spanish

Honest Care

For those without chronic conditions who are seeking a plan with extra benefits and the flexibility to see the doctor of their choice with no referral required.

English

Spanish

2023 Benefits Beyond Medicare

Dental

For more information, please reference the Summary of Benefits or Evidence of Coverage.

LIBERTY Dental Plan

www.libertydentalplan.com

Hearing

For more information, please reference the Summary of Benefits or Evidence of Coverage

Hearing

NationsBenefits

www.nationsbenefits.com

Vision

For more information, please reference the Summary of Benefits or Evidence of Coverage.  

Vision

VSP

www.vsp.com

Transportation

For more information, please reference the Summary of Benefits or Evidence of Coverage.

Companion Care

For more information, please reference the Summary of Benefits or Evidence of Coverage.

Papa Pal

www.papa.com

Fitness

For more information, please reference the Summary of Benefits or Evidence of Coverage.

Meal Delivery

For more information, please reference the Summary of Benefits or Evidence of Coverage.