Pharmacy Plan (HMO) 008

For members who need prescription coverage and reside in Western Washington. If you regularly take two or more prescription medications or have certain conditions with higher cost drug treatment, this plan is for you.

Click the button below to learn how to enroll in this plan.

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2019 Plan Benefits at a Glance

Coverage in this Plan Includes:

Medical, vision, prescription drugs, gym membership and more.

Community HealthFirst Original Medicare
Premium $68* Part B Premium
Pharmacy Tier 5 Preferred Pharmacy, 33% coinsurance Not Covered
Vision $0 copay, limit one exam per year. Up to $100 every two years for prescription eye wear Not Covered
Dental $0 copay, limit one exam per year. Up to $500 per year in additional routine coverage Not Covered
Podiatry $0 copay (up to 4 supplemental routine visits per year) Not Covered
Acupuncture $0 copay ($250 benefit limit per year) Not Covered
Fitness Program No-cost basic gym membership or up to 2 Home Fitness kits per year Not Covered

*You must continue to pay your Medicare Part B premium.

The Summary of Benefits booklet gives you an idea of what services we cover and how much you pay. It does not list every service that we cover or list every limitation or exclusion.

➔ Summary of Benefits

Offered in the Following Counties:

Clark, Cowlitz, King, Kitsap, Pierce, Snohomish, Spokane, and Thurston.

Covered Services & Cost

The Evidence of Coverage lays out coverage and payment details for different services including copays, coinsurance, limitation, prior authorizations, and deductibles.

➔ Download the Evidence of Coverage

Prescription Coverage

Check the formulary that corresponds to your plan on our Prescription Coverage page for coverage, copays, and limitations. You can download a PDF or you can search for your medications by name in the online formulary.

➔ Check prescription coverage

Has Anything Changed in 2019?

That’s a great question. Any changes to the plan are detailed in the Annual Notice of Change (ANOC).

➔ Download the 2019 Annual Notice of Change

Special Benefits

Silver & Fit Program

Stay fit at home or at the gym with the Silver & Fit Program. Meet new people, participate in challenges, and earn rewards while you get exercise to keep you active and healthy.

➔ Explore Silver & Fit

DID YOU KNOW...?

Dental Coverage

Keeping your teeth and gums healthy is an important part of your whole health care plan. Dental coverage is included on select plans for yearly cleanings, x-rays, fluoride treatments, and other limited services.

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