Arizona

Gold Heart & Diabetes Complete

(H4869-002)

For those who are Medicare- and Medicaid-eligible with cardiovascular disorders, chronic heart failure, and/or diabetes
Counties: Gila, Maricopa, Pima, Pinal

$0 / $10.90

Monthly premium¹

0% / 20%

Copay for PCPs¹

0% / 20%

Copay for most specialists¹
$4,000 Flex allowance per year
This allowance is distributed quarterly, with rollover, for dental, vision, and hearing expenses
4G Smartphone*
This benefit is supplied through Gold Kidney’s mobile phone and services partner and includes unlimited talk, text, and data
$600 Gold Perks Plus allowance per year
This benefit package is distributed monthly, without rollover, for the purchase of plan-defined product and service categories
$1,800 healthy food allowance* per year
This allowance is distributed monthly, without rollover, for healthy food, produce, and prepared meals
24 one-way trips to medical appointments per year
This benefit is for non-emergency transportation to health-related locations
$300 fuel & rideshare allowance* per year
This allowance is distributed monthly, without rollover, for fuel and rideshare expenses

Rx Benefits

Rx deductible

$590
This is what you will pay before Gold Kidney starts paying for covered prescription medications

30-day Rx copay
(Tiers 1-5)

25% / 25% / 25% / 25% / 25%
This is what you will pay for prescription medications

100-day mail order Rx
(Tiers 1–5)

25% / 25% / 25% / 25% / 25%
This is what you will pay for a long-term supply of prescription medications through a convenient mail-order service

Gold Perks

  • Over-the-counter items (OTC)
  • Fitness activity fees
  • Therapeutic massage
  • Home and bathroom safety devices

Gold Perks Plus

$600 Annual Allowance
  • Utility bills*
  • Pest control services*
  • Over-the-counter items (OTC)
  • Indoor air quality equipment and Services*
  • Therapeutic massage
  • Personal care services*
  • Fitness activity fees
  • Home and bathroom safety devices
  • Pet supplies and services*

Additional Benefits**

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

$4,000 annual Flex allowance for dental, vision, and hearing, with quarterly rollover

4G smartphone with unlimited talk, text, and data*

$1,800 annual allowance for healthy food, and produce*

2 prepared meals per day, for 14 days, up to 4 times per year following surgery or an in-patient hospitalization

24 one-way trips per year for non-emergency transportation to health-related locations

$300 annual allowance for fuel and rideshare services*

Up to $300 annually in Rewards & Incentives for preventive health activities

Silver&Fit gym membership with a comprehensive fitness and well-being program

60 hours of in-home companionship and support annually

Wearable personal emergency response device equipped with GPS and fall-detection

An older couple standing and smiling under a tree in Arizona

Ready to get started?

The process is easy!

Want more plan details?

Summary of Benefits
Summary of Benefits (Span)

Ready to enroll?

Enroll Now

Have more questions?

Contact Us

¹If you receive Medicaid/AHCCS benefits, your premium and coinsurance will be paid by these programs.

*Requires one of the CMS-listed chronic illnesses, SSBCI program requirements, and participation in the Gold Kidney’s care management program for C-SNP plan members. Learn more about SSBCI here

Go Back to Results
View All Plans