Limitations and exclusions may apply. The cost-sharing for this plan is divided as follows: Tier 1 ( Preferred Generic) contains 444 drugs and has a co-payment of $4.00. Call Member Services for more information. The drugs listed are for comparison purposes and may differ in effectiveness, dosing, side effects and/or drug interaction profiles. If your drug is not listed, it does not require prior authorization. Personally Provided Information If you choose to provide us with personal information by sending an email, or by filling out a form with your personal information and submitting it through our Web site, we use that information to respond to your message and to help us provide you with information or material that you request. Please contactwww.medicare.govor1-800-MEDICARE(TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information about Medicare plan options. Johns Hopkins Advantage MD Medicare Advantage Plans with Part D Supplies like meters, lancets, and test strips can be purchased at a network pharmacy, but nebulizers and other equipment must be purchased through a DME vendor. also provides the following benefits. Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Llame al 877-293-5325 (TTY: 711) Chinese: 877-293-5325 (TTY: 711). For prescription drug on formulary at in-network pharmacy. Medicare has neither approved nor endorsed any information on this site. Waiver of Liability Statement. Look for your drug on the list. Excited about the expansion of Johns Hopkins Advantage MD Medicare Advantage products in 2023. Review quality measures. Claims - Hopkins Medicine This page features plan details for 2023 Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Johns Hopkins Advantage MD (HMO) Quick Reference Guide To obtain the most up-to-date information on policies, manuals, directories and other Your prescription must be filled at a network pharmacy, and your cost is determined by your plans tier cost sharing amount (copay or coinsurance). LifeBridge Health Becomes Part Owner In Johns Hopkins Medicare The full BAE policy is available atCMS.gov. Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. The directions on how to file an appeal are in your notification letter or in Chapter 9 of your Evidence of Coverage. Foreign Language Assistance: Spanish: ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Current Members: . Note: This is not a complete list of all formulary alternatives covered by your Part D plan. Unless you obtain an authorization or exception, we cannot continue to pay for these medications under the transition policy, even if you have been a member for less than 90 days following your 30-day transition supply. Once Advantage MD reviews the request, you will be notified of the decision via phone and mail. Your provider may request an exception to the step therapy for specific circumstances that warrant a need for a non-preferred product. 2023 Medicare Advantage Plan Benefits explained in plain text. You must have both Part A and . DO NOT BILL MEDICARE Medicare limiting charges apply. For over 125 years, Marylanders have counted on Johns Hopkins for health care. If you are outside of the transition period and are experiencing circumstances that involve a level of care change (moving from home to a long-term care facility, or from a long-term care facility to home), the pharmacist who refills your prescription will be able to provide you up to a 31-day supply (unless you have a prescription written for fewer days) of your medications. Always seek the advice of your doctor regarding your prescription medications. Authorization Form - Johns Hopkins Advantage MD - hopkinsmedicare.com Scranton, PA 18505. This page features plan details for 2023 Johns Hopkins Advantage MD D-SNP (HMO D-SNP) H1225 - 003 - 0 available in Anne Arundel, Howard and Montgomery Counties. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. Milton S. Eisenhower Library. Johns Hopkins Advantage MD D-SNP (HMO D-SNP) We do not give, share, sell, or transfer any personal information to a third party unless required bylaw. Enroll on the phone or online! Spanish. The Johns Hopkins Advantage MD Plus (PPO)'s formulary is divided into 5 tiers. Johns Hopkins Advantage MD D-SNP is an HMO D-SNP plan with a Medicare contract and a State of Maryland Medicaid contract. What to Consider When Shopping for Medicare, Johns Hopkins Advantage MD H1225-001 (HMO), $325 per day for days 1 through 5 / $0 per day for days 6 through 90, $0 per day for days 1 through 20 / $160 per day for days 21 through 100, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Medicare Advantage Plus Prescription Drug Plans in Maryland, Medicare Advantage Plus Prescription Drug Plans in 20701 (Anne Arundel County), Johns Hopkins Advantage MD Medicare Advantage Plus Prescription Drug Plans in Maryland, Find Continuing Care Retirement Communites, California Do Not Sell My Personal Information Request. Johns Hopkins Advantage MD D-SNP is an HMO D-SNP plan with a Medicare . When you receive a transition fill letter, you should speak to the plan and/or your physician regarding whether you should change the drug you are currently taking, or request an authorization or exception from the plan to continue coverage of this drug. Not affiliated with or endorsed by any government agency. AdvantageMD - hopkinsmedicare.com Spanish. Call 1-877-354-4611 TTY 711, $10.35 copay or 5% (whichever costs more), $0 copay (limits may apply) (authorization required) (referral not required), $0 copay (authorization required) (referral not required), $0 copay (authorization not required) (referral required), $0 copay (authorization not required) (referral not required), $0 copay (limits may apply) (authorization not required) (referral not required), Covered (authorization not required) (referral not required). We do not offer every plan available in your area. All insurance agents and enrollment platforms linked to this site have their own terms and conditions. Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Your prescription must be filled at a network pharmacy, and your cost is determined by your plans tier cost sharing amount (copay or coinsurance). Out-of-network/non-contracted providers are under no obligation to treat Johns Hopkins Advantage MD members, except in emergency situations. Enrolling is quick and easy. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227 . Would you like to continue? P.O. Advantage MD serves Anne Arundel, Baltimore, Carroll, Frederick, Howard, Montgomery, Somerset, Washington . For additional information about this plan(s), please contact Johns Hopkins Advantage MD. John Hopkins Community Physicians in Downingtown, PA with Reviews - YP.com If you have questions about BAE or need help getting documented proof, please call Member Services. Important Message About What You Pay for Insulin You wont pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier its on. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Remember, by switching to an alternative generic or brand-name drug included on our formulary, you can avoid paying the full cost for a non-formulary drug. ? A thirty (30) day supply is the maximum transition amount, and could be less if your prescription is written for fewer days. Johns Hopkins Advantage MD Medicare Advantage Plans | US News Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services. Also, when adding the new generic drug, we may decide to keep the brand name drug on our Drug List, but immediately move it to a different cost-sharing tier or add new restrictions. Out-of-network/non-contracted providers are under no obligation to treat Johns Hopkins Advantage MD members, except in emergency situations. Medicare - Health Care Reimbursement - Guides at Johns Hopkins University. Looking for2022 Prescription Drug Coverage? Johns Hopkins Advantage MD (HMO) - US News Health Johns Hopkins Advantage MD D-SNP (HMO D-SNP) Johns Hopkins Advantage MD is available to residents of these counties: document.getElementById( "ak_js_2" ).setAttribute( "value", ( new Date() ).getTime() ); I would like a representative to call me to speak about questions regarding enrolling in a plan. All preferred and non-preferred Part B drugs are identified on the Advantage MD Part B Prior Authorization List. Scranton, PA 18505. Johns Hopkins in Downingtown, PA with Reviews We may remove drugs from the formulary, add prior authorization, quantity limits and/or step therapy restrictions on a drug, and/or move a drug to a higher cost-sharing tier during the plan year. However, if the U.S. Food and Drug Administration (FDA) deems a drug on our formulary to be unsafe or if the drugs manufacturer removes a drug from the market, we will immediately remove the drug from the formulary and notify all affected members as soon as possible. Offered throughout most of Maryland, a Johns Hopkins Medicare Advantage plan provides you with comprehensive Medicare coverage including Medicare Part D drug coverage. Online Research Consultation. provides the following cost-sharing on drugs. See the Part D Premium Reduction section below for more details. This is a 3-star Medicare Advantage plan with Part D (prescription drug) coverage. Johns Hopkins HealthCare hiring Medicare Marketing Specialist in For USFHP paper claims, mail to: Johns Hopkins HealthCare PO Box 830479 Birmingham, AL 35283 Attn: USFHP Claims Submission. How this plan performs for drug pricing, patient safety, member experience and more. When your annual out-of-pocket costs exceed $6,350. We do not offer every plan available in your area. 8am - 6pm. From April 1September 30, you will need to leave a message on weekends and holidays. This effort requires us to ensure that our members receive only treatment that is medically necessary, according to current standards of practice. offers the following coverage and cost-sharing. Certain medical injectable drugs also require prior authorization or step therapy. Johns Hopkins Advantage MD | Maryland Medicare Advantage Plan IMPORTANT : This page has been updated with plan and premium data for the 2023 Medicare Annual Enrollment Period (AEP). TTY . 8am - 6pm. The Johns Hopkins Advantage MD comprehensive formulary is a complete list of Medicare-approved, prescription brand-name and generic medications we cover. A screen print from the States Medicaid systems showing your Medicaid status. Find 1 listings related to John Hopkins Community Physicians in Downingtown on YP.com. You can also submit and check the status of claims through HealthLINK@Hopkins, the secure, online Web portal for JHHC providers and Priority Partners, EHP and . You should share a copy of the decision with your doctor so you and your doctor can discuss next steps. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Availability of TTY Services and Foreign Language Interpretation when Prospective Members Call the Drug Plan, Member Complaints and Changes in the Drug Plan's Performance, Complaints about the Drug Plan (More Stars Are Better because It Means Fewer Complaints), Improvement (if Any) in the Drug Plan's Performance, Ease of Getting Prescriptions Filled when Using the Plan, Plan Provides Accurate Drug Pricing Information for Medicare's Plan Finder Website, Taking Blood Pressure Medication as Directed, Taking Cholesterol Medication as Directed, Members Who Had a Pharmacist (or Other Health Professional) Help Them Understand and Manage Their Medications, The Plan Makes Sure Members with Diabetes Take the Most Effective Drugs to Treat High Cholesterol. Johns Hopkins Advantage MD Medicare Advantage Plans in Maryland Johns Hopkins Advantage MD Medicare Advantage Plans with Part D in 10am - 6pm. You may obtain a print version of your formulary by calling us. Heart Health Archives - Johns Hopkins Advantage MD Privacy Practices Terms & Conditions Accessibility Interoperability Medicare.gov, Notice of Nondiscrimination: H1225 003 0 available in Anne Arundel, Howard and Montgomery Counties. Please refer to your EOC for more detailed information on Johns Hopkins Advantage MD Medicare Transition Process. Find 1 listings related to Johns Hopkins in Downingtown on YP.com. Johns Hopkins Advantage MD is available to residents of these counties: document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); I would like a representative to call me to speak about questions regarding enrolling in a plan. Medicare Coverage. This field is for validation purposes and should be left unchanged. Staying Healthy: Screenings, Tests and Vaccines, Members Whose Plan Did an Assessment of Their Health Needs and Risks, Yearly Review of All Medications and Supplements Being Taken, Yearly Pain Screening or Pain Management Plan, Osteoporosis Management in Women Who Had a Fracture, Eye Exam to Check for Damage from Diabetes, Kidney Function Testing for Members with Diabetes, Plan Members with Diabetes Whose Blood Sugar Is under Control, The Plan Makes Sure Member Medication Records Are Up-to-Date after Hospital Discharge, The Plan Makes Sure Members with Heart Disease Get the Most Effective Drugs to Treat High Cholesterol, Ease of Getting Needed Care and Seeing Specialists, Health Plan Provides Information or Help when Members Need It, Coordination of Members' Health Care Services, Member Complaints and Changes in the Health Plan's Performance, Complaints about the Health Plan (More Stars Are Better because It Means Fewer Complaints), Members Choosing to Leave the Plan (More Stars Are Better because It Means Fewer Members Choose to Leave the Plan), Improvement (if Any) in the Health Plan's Performance, Health Plan Makes Timely Decisions about Appeals, Fairness of the Health Plan's Appeal Decisions, Based on an Independent Reviewer, Availability of TTY Services and Foreign Language Interpretation when Prospective Members Call the Health Plan, Diagnostic radiology services (e.g., MRI), Prosthodontics, other oral/maxillofacial surgery, other services, Outpatient group therapy visit with a psychiatrist, Outpatient individual therapy visit with a psychiatrist, Physical therapy and speech and language therapy visit, Durable medical equipment (e.g., wheelchairs, oxygen), Prosthetics (e.g., braces, artificial limbs). Diabetes testing supplies are covered under Medicare Part B. Any information we provide is limited to those plans we do offer in your area. See reviews, photos, directions, phone numbers and more for Johns Hopkins locations in Downingtown, PA. . Notice of Nondiscrimination: Johns Hopkins Advantage MD (PPO) and Johns Hopkins Advantage MD (HMO) comply with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Medicare Advantage plus Prescription Drug plans are an alternative . Would you like to continue? Not all plans offer all of these benefits. Pharmacy & Formulary - Hopkins Medicine Enrollment in Johns Hopkins Advantage MD, HMO, PPO or D-SNP (HMO) depends on contract renewal. This page was last updated: October 14, 2022 at 8:56 pm EST. Mon-Fri 8am-9pm EST | Sat 8am-8pm EST. Important Message About What You Pay for Vaccines Our plan covers most Part D vaccines at no cost to you. Box 3538 2023 Johns Hopkins Advantage MD | Johns Hopkins Advantage MD Tribute Once we receive your BAE, we will ask CMS to update your LIS status in its systems. Llame al 877-293-5325 (TTY: 711) Chinese: 877-293-5325 (TTY: 711). Benefits may vary by carrier and location. Please contact Medicare.gov or 1-800- MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options. I would like a representative to call me to speak about questions regarding enrolling inaplan, Care and Resources for Members with Diabetes, 5 Reasons To Make This Health Plan Part Of Your Retirement, Your Personal Care Plan for All Advantage MD Members, 60-minute heart disease workshop for adults. You must have both Part A and . After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $7,400.00, you will pay no more than the greater of the two amounts listed below for generic and brand-name drugs. Our formulary is updated monthly and as formulary changes occur. You have secure access to all of your personal prescription benefit information so you can easily manage your health online where and when you need to. Please contact your provider to determine next steps. If you are taking the brand name drug at the time we make the change, we will provide you with information about the specific change(s) we made. PPO members: 877-293-5325 (TTY: 711) HMO members: 877-293-4998 (TTY: 711) For more information, refer to Chapter 2 in your Evidence of Coverage. Log in to your HealthLINK account to view information on your EHP/Priority Partners/Advantage MD patients. Low income subsidy (LIS), also known as Extra Help, is a program that helps individuals who have a limited income pay for their Medicare prescription drug costs. is a Medicare Advantage (Part C) Special Needs Plan by Johns Hopkins Advantage MD. Ready to sign up for Johns Hopkins Advantage MD D-SNP (HMO D-SNP) If you have questions about BAE or need help getting documented proof, please call Member Services. Whole Health Assessment Form. 2023 Part D Coverage Determinations and Appeals, 2022 Part D Coverage Determinations and Appeals, 2023 Medication Therapy Management Program, 2022 Medication Therapy Management Program, I would like a representative to call me to speak about questions regarding enrolling inaplan, Plan Specific Prescription Drug Coverage Resources, Medications requiring prior authorization, Errata (List of Changes to PPO Formulary), PPO, PPO Plus, PPO Premier Formulary Search Tool, Errata (List of Changes to HMO Formulary), Errata (List of Changes to HMO D-SNP Formulary), Advantage MD Part B Prior Authorization List, PPO, PPO Plus, PPO Premier Comprehensive Formulary (effective 1/1/23) , HMO D-SNP Comprehensive Formulary (effective 1/1/23) , PPO, PPO Plus, PPO Premier Comprehensive Formulary . This will also include information on the steps you may take to request an exception to cover the brand name drug. This field is for validation purposes and should be left unchanged. If you believe that you are not paying the correct monthly premium or costs for your drugs and are eligible for extra help/LIS, you can submit the Best Available Evidence (BAE) to Advantage MD. This page was last updated: October 28, 2022 at 12:36 pm EST. Look up plan benefits. Johns Hopkins Advantage MD D-SNP (HMO D-SNP) After the total drug costs paid by you and the plan reach $4,660, up to the out-of-pocket threshold of $6,350. If you were taking a non-formulary drug or a prescription drug with a Step Therapy or a Prior Authorization restriction before you joined Johns Hopkins Advantage MD and you reside in a Long Term Care facility, the pharmacist who refills your prescription will be able to provide you with up to a 31-day supply of your prescription drug unless you have a prescription written for fewer days during the first 90 days of your membership in our plan. Important Message About What You Pay for Insulin You wont pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier its on. Baltimore - December 8, 2016. IMPORTANT: This page has been updated with plan and premium data for the 2023 Medicare Annual Enrollment Period (AEP). O'Brien Johns. Johns Hopkins Advantage MD is a Medicare Advantage Plan with a Medicare contract offering HMO and PPO products. Any information we provide is limited to those plans we do offer in your area. If you are affected by formulary changes from one contract year to the next, you may be eligible to receive a temporary 30-day supply of your prescription drug within the first 90 days of the new plan year while you work with your doctor to either obtain a covered alternative prescription drug or request a formulary exception. Staying Healthy: Screenings, Tests and Vaccines, Members Whose Plan Did an Assessment of Their Health Needs and Risks, Yearly Review of All Medications and Supplements Being Taken, Yearly Pain Screening or Pain Management Plan, Osteoporosis Management in Women Who Had a Fracture, Eye Exam to Check for Damage from Diabetes, Kidney Function Testing for Members with Diabetes, Plan Members with Diabetes Whose Blood Sugar Is under Control, The Plan Makes Sure Member Medication Records Are Up-to-Date after Hospital Discharge, The Plan Makes Sure Members with Heart Disease Get the Most Effective Drugs to Treat High Cholesterol, Ease of Getting Needed Care and Seeing Specialists, Health Plan Provides Information or Help when Members Need It, Coordination of Members' Health Care Services, Member Complaints and Changes in the Health Plan's Performance, Complaints about the Health Plan (More Stars Are Better because It Means Fewer Complaints), Members Choosing to Leave the Plan (More Stars Are Better because It Means Fewer Members Choose to Leave the Plan), Improvement (if Any) in the Health Plan's Performance, Health Plan Makes Timely Decisions about Appeals, Fairness of the Health Plan's Appeal Decisions, Based on an Independent Reviewer, Availability of TTY Services and Foreign Language Interpretation when Prospective Members Call the Health Plan. 8 a.m.-8 p.m., 7 days a week. plan_benefits - Hopkins Medicine Johns Hopkins Advantage MD offers preferred provider organization (PPO) plans and health maintenance organization (HMO) plans with Medicare Part D prescription drug coverage for Medicare-eligible residents in Maryland. Johns Hopkins Advantage MD D-SNP is an HMO D-SNP plan with a Medicare contract and a State of Maryland Medicaid contract. We do not directly sell health insurance or offer professional legal, medical, or financial advice. Whatever Your Needs, Johns Hopkins Has You Covered. A copy of your Medicaid card, which includes your name and the eligibility date. Who you are:As a Medicare Marketing Specialist for Johns Hopkins HealthCare, you are an experiencedSee this and similar jobs on LinkedIn. Yes No. 12pm - 5pm. M-level Service Desk. $10.35 copay or 5% (whichever costs more), Diagnostic radiology services (e.g., MRI), Prosthodontics, other oral/maxillofacial surgery, other services, Outpatient group therapy visit with a psychiatrist, Outpatient individual therapy visit with a psychiatrist, Physical therapy and speech and language therapy visit, Durable medical equipment (e.g., wheelchairs, oxygen), Prosthetics (e.g., braces, artificial limbs). Your provider is aware of how to submit this request. Use our pharmacy locator tool to find a pharmacy in your area where you can get your prescriptions, or skip the trip and have your prescriptions mailed to your home through our mail order pharmacy program: If you need help finding a PPO network pharmacy, please call us toll-free at 877-293-5325(TTY:711). Acceptable forms of Best Available Evidence include: You must mail one of the accepted forms of BAE to: Johns Hopkins Advantage MD How this plan performs in coverage of conditions, screenings, customer service and more. Foreign Language Assistance: Spanish: ATENCIN: si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Once you reach that amount, you will enter the next coverage phase. Advantage MD Forms - Hopkins Medicine Advantage MD Coronavirus (COVID-19) - Hopkins Medicine The list of changes that have been made to the formulary is called the errata. Call Member Services for more information. 1700 Spruce St. Philadelphia, PA 19103. Prospective Members: 1-888-403-7682. You are about to leave the Johns Hopkins Advantage MD website. What to Consider When Shopping for Medicare, Johns Hopkins Advantage MD Tribute H1225-004 (HMO), $350 per day for days 1 through 5 / $0 per day for days 6 through 90, $0 per day for days 1 through 20 / $196 per day for days 21 through 100, Best Continuing Care Retirement Community (CCRC), Best Medicare Advantage Plan Companies 2023, Medicare Advantage Plans in 20701 (Anne Arundel County), Johns Hopkins Advantage MD Medicare Advantage Plans in Maryland, Find Continuing Care Retirement Communites, California Do Not Sell My Personal Information Request. Johns Hopkins Advantage MD PO Box 3537 Scranton, PA 18505 Present this card at the time of service and with every prescription. 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Note: this page was last updated: October 28, 2022 at 12:36 pm EST ( 1-800-633-4227 PA Present. Except in emergency situations: //www.factsonmedicare.com/medicare-advantage/johns-hopkins-advantage-md-d-snp-hmo-d-snp-h1225-003-0/ '' > johns hopkins medicare advantage /a > Spanish of Maryland Medicaid contract professional. S formulary is a 3-star Medicare Advantage plan with a Medicare contract and a State of Maryland, Johns! Advantage plan with a Medicare Advantage Plus prescription drug plans are an alternative about plan. About the expansion of Johns Hopkins Advantage MD serves Anne Arundel, Baltimore, Carroll, Frederick Howard! Please johns hopkins medicare advantage to your EOC for more details AEP ) endorsed by any agency. Or offer professional legal, medical, or financial advice products in 2023. Review quality measures drugs! Drug pricing, patient safety, member experience and more expansion of Johns Hopkins Advantage MD,...