2024 Plan Comparison

ARIZONA

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 Kidney Disease (ESKD) requiring any mode of dialysis. Dialysis Plus is designed for Medicare members and Dialysis Complete is designed for members with Medicare and Medicaid.

Gold Circle

For those with cardiovascular disorders, chronic heart failure, and/or diabetes looking for a plan similar to original Medicare with additional food and fuel benefits.

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.

Essential Care

For those who need only a few supplemental benefits and do not need prescription drug coverage.

Why Choose a Gold Kidney Health Plan?

Members have the flexibility to choose their own provider without paying more. With a Gold Kidney Medicare Advantage plan all medical benefits are offered at the same cost. 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.

2024 Summary of Benefits

Benefits Beyond Medicare

Full Plan Comparison

Medicare Advantage Plan – H4869-001

Super Plus (HMO-POS C-SNP)

For Medicare members with cardiovasular disorders, chronic heart failure, and / or diabetes

Monthly Premium

$0

Part B Premium Rebate

$50

Maximum Out-of-Pocket

$3,000

Deductible
$0
Primary care copay
$0
Specialist copay*
$0-$10
Inpatient hospitalization
$175 (days 1-5)
$0 (days 6-90)
Outpatient Surgery
$75-$175
Rx deductible
$0
Rx copay (Tiers 1-6)
($0 Insulin Copay**)
$0/$5/$40/
$100/33%/$0
Gap Coverage - Tiers 1, 2, 3(partial), and 6***
$0-$12

*Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have $10 copay

**Refer to the Summary of Benefits for specific benefits and coverage amounts

***Tiers 1 and 6 are $0, Tier 2 is $5, and many Tier 3 are $12

Additional Benefits**

  • $2,500 annual Flex allowance for dental, vision, and hearing

  • 36 one-way trips for non-emergency transport

  • $300 annually for over-the-counter items

  • In-home companion care

  • Personal Emergency Response System available

  • Meal program post-surgery or in-patient stay

  • $960 annual healthy grocery allowance (SSBCI)

  • Worldwide emergency travel coverage

Medicare Advantage Plan – H4869-002

Super Complete (HMO-POS C-SNP)

For those who have Medicare and Medicaid coverage

Monthly Premium*

$0 – $25.80

Part B Premium Rebate

$0

Maximum Out-of-Pocket

$8,850

Deductible*
$0-$240
Primary care copay
0%-20%
Specialist copay**
0%-20%
Inpatient hospitalization*
(Medicare Part A deductible may apply)
$0 (days 1-60)
$0-$400/day (days 61-90)
Outpatient Surgery
$75-$175
Rx deductible***
$0-$545
Rx copay** (Tiers 1-6)
25% or $0-$10.35

*Refer to the Summary of Benefits for specific benefits and coverage amounts

**Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have 0% copay for Medicare+Medicaid or 20% copay for Medicare only

***Amount could be $0 if you receive “Extra Help”

Additional Benefits*

  • $4,000 annual Flex allowance for dental, vision, and hearing

  • 54 one-way trips for non-emergency transport

  • $1,620 annually for over-the-counter items

  • In-home companion care

  • Personal Emergency Response System available

  • Meal program post-surgery or in-patient stay

  • $900 annual healthy grocery allowance (SSBCI)

  • Worldwide emergency travel coverage

Medicare Advantage Plan – H4869-003

Dialysis Plus (HMO-POS C-SNP)

For Medicare members with End-Stage Kidney Disease (ESKD) requiring any mode of dialysis

Monthly Premium

$0

Part B Premium Rebate

$0

Maximum Out-of-Pocket

$2,700

Primary care copay
$0
Specialist copay**
$0-$10
Inpatient hospitalization
$175/day (days 1-5)
$0 (days 6-90)
Outpatient Surgery
$75-$175
Dialysis
$0
Rx deductible
$0
Rx copay** (Tiers 1-6)
($0 Insulin Copay**)
$0/$5/$40
$100/33%/$0
Gap Coverage - Tiers 1, 2, 3
(partial), and 6***
$0-$12

*Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have $10 copay

**Refer to the Summary of Benefits for specific benefits and coverage amounts

***Tiers 1 and 6 are $0, Tier 2 is $5, and many Tier 3 are $12

Additional Benefits**

  • $2,500 annual Flex allowance for dental, vision, and hearing

  • Unlimited one-way trips for non-emergency transport

  • $300 annually for over-the-counter items

  • In-home companion care

  • Personal Emergency Response System available

  • Meal program post-surgery or in-patient stay

  • $900 annual healthy grocery allowance (SSBCI)

  • Worldwide emergency travel coverage

Medicare Advantage Plan – H4869-004

Dialysis Complete (HMO-POS C-SNP)

For those who have Medicare and Medicaid

Monthly Premium*

$0 – $37.80

Part B Premium Rebate

$0

Maximum Out-of-Pocket

$8,850

Deductible*
$0-$240
Primary care copay
0%-20%
Specialist copay**
0%-20%
Inpatient hospitalization*
(Medicare Part A deductible may apply)
$0 (days 1-60)
$0-$400/day (days 61-90)
Outpatient Surgery
$75-$175
Dialysis
0%-20%
Rx deductible***
$0-$545
Rx copay*** (Tiers 1-6)
25% or $0-$10.35

*Refer to the Summary of Benefits for specific benefits and coverage amounts

**Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have 0% copay for Medicare+Medicaid or 20% copay for Medicare only

***Amount could be $0 if you receive “Extra Help”

Additional Benefits*

  • $4,000 annual Flex allowance for dental, vision, and hearing

  • 54 one-way trips for non-emergency transport

  • $1,620 annually for over-the-counter items

  • In-home companion care

  • Personal Emergency Response System available

  • Meal program post-surgery or in-patient stay

  • $900 annual healthy grocery allowance (SSBCI)

  • Worldwide emergency travel coverage

Medicare Advantage Plan – H4869-010

Gold Circle (HMO-POS C-SNP)

For Medicare members with cardiovascular disorders, chronic heart failure, and/or diabetes who desire additional food and fuel benefits

Monthly Premium

$0

Part B Premium Rebate

$0

Maximum Out-of-Pocket

$8,850

Primary care copay
20%
Specialist copay*
20%
Inpatient hospitalization
(Medicare Part A deductible applies)
$0 (days 1-60)
$0-400 (days 61-90)
Outpatient Surgery
$75-$175
Rx deductible
$545
Rx copay** (Tiers 1-6)
25%

*Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have 20% copay

**Refer to the Summary of Benefits for specific benefits and coverage amounts

Additional Benefits**

  • $300 annual healthy grocery allowance (SSBCI)

  • $300 annual fuel allowance (SSBCI)

  • $300 annual Preventative Rewards and Incentives

Medicare Advantage Plan – H4869-005

Honest Care (HMO-POS)

For those without chronic conditions who seek extra benefits and more flexbility

Monthly Premium

$0

Part B Premium Rebate

$50

Maximum Out-of-Pocket

$3,000

Primary care copay
$0
Specialist copay*
$0-$10
Inpatient hospitalization
$175/day (days 1-7)
$0 (days 8-90)
Outpatient Surgery
$75-$175
Rx deductible
$0
Rx copay** (Tiers 1-6)
($0 Insulin Copay**)
$0/$5/$40
$100/33%/$0
Gap Coverage - Tiers 1, 2, 3
(partial), and 6***
$0-$12

*Cardiology, nephrology, endocrinology, cardiovascular surgeon; allother specialists have $10 copay

**Refer to the Summary of Benefits for specific benefits and coverageamounts

***Tiers 1 and 6 are $0, Tier 2 is $5, and many Tier 3 are $12

Additional Benefits**

  • $2,100 annual Flex allowance for dental, vision, and hearing

  • 24 one-way trips for non-emergency transport

  • $300 annually for over-the-counter items

  • In-home companion care

  • Personal Emergency Response System available

  • Meal program post-surgery or in-patient stay

  • $540 annual healthy grocery allowance (SSBCI)

  • Worldwide emergency travel coverage

Medicare Advantage Plan – H4869-009

Essential Care (HMO-POS MA)

For those who need only a few supplemental benefits and do not need prescription drug coverage.

Monthly Premium

$0

Part B Premium Rebate

$100

Maximum Out-of-Pocket

$8,850

Deductible
$240
Primary care copay
20%
Specialist copay*
20%
Inpatient hospitalization
(Medicare Part A deductible applies)
$0 (days 1-60),
$0-$400/day (days 61-90)
Outpatient Surgery
$75-$175
Rx deductible
N/A
Rx copay (Tiers 1-6)
N/A

*Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have 20% copay

**Refer to the Summary of Benefits for specific benefits and coverage amounts

Additional Benefits**

  • $900 annual healthy grocery allowance (SSBCI)

  • $900 annual fuel allowance (SSBCI)

  • $300 annual Preventative Rewards and Incentives

2024 Summary of Benefits (Arizona)

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 Kidney Disease (ESKD) 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

Gold Circle

For those with cardiovascular disorders, chronic heart failure, and/or diabetes and who is looking for a plan similar to original Medicare with additional food and fuel benefits.

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

Essential Care

For those with existing prescription drug coverage who need only a few supplemental benefits.

English

Spanish

2024 Benefits Beyond Medicare

Flex Card Benefits

Our Medicare Advantage plans include dental, hearing, vision, and more. Members are able to choose their providers without being concerned about whether they are in or out of network. 

Flex card benefits include:

  • Dental, hearing, and vision
  • Rewards and incentives
  • Special supplemental benefits for the chronically ill
  • Over-the-Counter (OTC) medication

Members receive a quarterly allowance for benefits. Generally, quarterly allowance balances do not roll from quarter.

LEARN MORE >

Transportation

Gold Kidney provides transportation benefits through an easy-to-use app that an be used for scheduling trips, or requesting on-demand trips.

Gold Kidney provides non-emergency transportation options for members with various mobility needs. Members can call or use an app on their phone to manage all their transportation needs, including the following services:

  • Curb to curb
  • Door to door
  • Hand to hand
  • Wheelchair
  • Stretcher
  • Non-emergency ambulance

No prior authorization is required, and one companion is allowed to accompany our members.

Companion Care

Our member benefits include support for everyday tasks  or companionship needs. 

We help connect members and their families to individuals who can provide companionship or help with everyday chores and tasks like grocery shopping, light housekeeping or yardwork, and technology assistance. 

Fitness

Gold Kidney offers the most comprehensive exercise and healthy aging programs available in the market through Silver&Fit. 

Gold Kidney has partnered with Silver&Fit to provide members with a variety of exercise and well-being options, including:   

  • Fitness center memberships –at gyms, exercise studios, and outdoor fitness programs   
  • Virtual personal training and home fitness kits   
  • Digital well-being resources and in-person healthy aging classes 

 

Meal Delivery

Gold Kidney offers meals to help those with chronic conditions manage their conditions or those recovering from a hospital stay. 

Homedelivered meals, designed by professional chefs and registered dieticians, for members who need help managing the nutritional aspects of their health conditions or who may need assistance with meals after surgery or hospital stay. Two meals per day for 14 days up to 4 times per year.  

Personal Emergency Response System

Gold Kidney provides a device for the member to be immediately connected with professionally trained operators who quickly assess the nature of a call and coordinate appropriate assistance.

  • Dispatch Center
  • Emergency Medical Services (EMS)
  • 24/7 Nurse Line
  • Case Management
  • Customer Service Support
  • Family and Caregiver Notifications

 English | Spanish

Nurse Advice Line

A dedicated service staffed by qualified and experienced nurses who provide medical assistance and guidance over the phone when members need it.  

Nurse Advice Lines are available 24/7 to help answer your questions or provide triage and referral services.

 

Remote Patient Monitoring

Gold Kidney offers remote patient monitoring services to remotely manage chronic health conditions from the comfort of our members’ homes.

Gold Kidney offers a platform that Includes an AI virtual health assistant, and clinical Insights and analytics that provide more Informed clinical decision-making, earlier Interventions, and better care. 

The monitored services can include a weight scale, blood pressure cuff, glucose monitor, and pulse oximeter.

Transplant Services

Gold Kidney offers access to transplant Centers of Excellence.  

Through our partners, we assess a member’s condition and coordinate care with providers to ensure the best opportunities for transplant success. Learn about our transplant network.

English: Arizona | Florida

Spanish: Arizona | Florida