2024 Plan Comparison
FLORIDA
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
Coming by 10/15/2023. Please check back!
Medicare Advantage Plan – H1526-001
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
$150
Maximum Out-of-Pocket
$3,000
$0 (days 6-90)
($0 Insulin Copay**)
$100/33%/$0
(partial), and 6***
*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 per year 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 – H1526-002
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
(Medicare Part A deductible may apply)
$0-$400/day (days 61-90)
*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*
-
$3,500 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
-
$420 annual healthy grocery allowance (SSBCI)
-
Worldwide emergency travel coverage
Medicare Advantage Plan – H1526-003
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
$0 (days 6-90)
($0 Insulin Copay**)
$100/33%/$0
(partial), and 6***
*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 – H1526-004
Dialysis Complete (HMO-POS C-SNP)
For those who have Medicare and Medicaid
Monthly Premium*
$0 – $36.30
Part B Premium Rebate
$0
Maximum Out-of-Pocket
$8,850
(Medicare Part A deductible may apply)
$0-$400/day (days 61-90)
($0 copay for Insulin)
*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*
-
$3,500 annual Flex allowance for dental, vision, and hearing
-
Unlimited 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
-
$420 annual healthy grocery allowance (SSBCI)
-
Worldwide emergency travel coverage
Medicare Advantage Plan – H1526-005
Honest Care (HMO-POS)
For those without chronic conditions who seek extra benefits and more flexbility
Monthly Premium
$0
Part B Premium Rebate
$150
Maximum Out-of-Pocket
$3,000
$0 (days 6-90)
$100/33%/$0
(partial), and 6***
*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**
-
$1,300 annual Flex allowance for dental, vision, and hearing
-
24 one-way trips for non-emergency transport
-
$300 per year over-the-counter items
-
In-home companion care
-
Personal Emergency Response System available
-
Meal program post-surgery or in-patient stay
-
$660 annual healthy grocery allowance (SSBCI)
-
Worldwide emergency travel coverage
Medicare Advantage Plan – H1526-006
Loyalty Care (HMO-POS)
This medical plan is for people who do not need prescription drug coverage.
Monthly Premium
$0
Part B Premium Rebate
$150
Maximum Out-of-Pocket
$4,400
$0 (days 6-90)
*Cardiology, nephrology, endocrinology, cardiovascular surgeon; all other specialists have $10 copay
**Refer to the Summary of Benefits for specific benefits and coverage amounts
Additional Benefits**
-
$2,500 annual Flex allowance for dental, vision, and hearing
-
$300 per year over-the-counter items
-
In-home companion care
-
Personal Emergency Response System available
-
Meal program post-surgery or in-patient stay
-
$660 annual healthy grocery allowance (SSBCI)
-
$300 annual fuel allowance (SSBCI)
2024 Summary of Benefits (Florida)
Super Plus & Super Complete
For those with cardiovascular disorders, chronic health failure, and/or diabetes. Super Plus is designed for Medicare members and Super Complete is designed for dual eligible Medicare and Medicaid members.
English
Spanish
Dialysis Plus & Dialysis Complete
For those with End-Stage Kidney Disease (ESKD) requiring any mode of dialysis. Dialsyis Plus is designed for Medicare members and Dialysis Complete is designed for dual eligible Medicare and Medicaid members.
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
Loyalty Care
This medical plan is for people who have separate prescription drug coverage.
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.
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.
Home–delivered 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.
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.