Skip to Main Content
Background Image: ""

Three Plans that Fit Your Needs

Samaritan Health Plans is the only locally-managed Medicare provider serving Benton, Lincoln and Linn counties. We’re proud to offer a range of benefits designed to keep you healthy.

Choose between our Conventional Plan (medical-only) and our Premier and Premier Plus plans (prescription drugs included). All Samaritan Advantage plans offer:

  • $0 deductibles
  • $3,750 out-of-pocket maximum
  • Coverage for acupuncture, chiropractic, skilled nursing facility services, worldwide emergency care, eyewear and more

New Benefit Options

icon of a tooth$1,000 for Dental Services (Premier Plan Plus only)
Use for filling, extractions, crowns etc. Orthodontia Excluded. Choose any dentist that accepts Medicare Advantage plans.

icon of a dumbellSamFit Membership (Conventional Plan and Premier Plan Plus only)
Enjoy the area’s premier 24/7 fitness center at no cost. 

icon of pill bottle$0 Copay for Tier 6 Drugs (Premier and Premier Plan Plus only)
Tier 6 includes select diabetic prescription drugs.

Overview of Plan Benefits

  Conventional Plan (HMO) Premier Plan (HMO) Premier Plan Plus (HMO)
Doctor Office Visits $5 per primary care visit
$20 per specialist visit
$15 per primary care visit
$35 per specialist visit
$15 per primary care visit
$35 per specialist visit
Hospitalization $200 per day for days 1–5
$0 after day 5
$1,750 out-of-pocket maximum
$300 per day for days 1–6
$0 after day 6
$1,750 out-of-pocket maximum
$300 per day for days 1–6
$0 after day 6
$1,750 out-of-pocket maximum
Outpatient Hospital Services $150 per outpatient hospital services and observation services
$100 per ambulatory surgical services
$200 per outpatient surgery 15% of the cost of outpatient surgery
Urgent Care — Nationwide $25  $35 $35
Dental — Choose any dentist that accepts Medicare Advantage plans $20 preventive visits N/A $25 preventive visits
$1,000 annual allowance for comprehensive care
SamFit 24/7 Fitness Center $0 membership N/A $0 membership
Part D Prescription Drug Benefits N/A Yes Yes
Tier 1: Preferred Generic N/A Up to $3 / one month Up to $3 / one month
Tier 2: Generic N/A Up to $9 / one month Up to $9 / one month
Tier 3: Preferred Brand N/A Up to $47 / one month Up to $47 / one month
Tier 4: Non-Preferred Drug N/A 48% 50%
Tier 5: Specialty Tier N/A 33% 33%
Tier 6: Select Care Drugs N/A $0 $0
Additional RX Gap Coverage N/A Generic - 37%
Brand - 25%
Tier 1: $3 or 37%, whichever is lower
Tier 2: $9 or 37%, whichever is lower
Tier 6: $0
Brand - 25%
Vision $20 for routine eye exam, 1 per year
$20 per Medicare-covered visit
$0 for routine eye exam, 1 per year
$35 per Medicare-covered visit
$35 for routine eye exam, 1 per year
$35 per Medicare-covered visit
Hearing Aid N/A N/A $500 per calendar year for hearing aids (all types)
both ears combined
Premium $70 / month $100 / month $129 / month
Additional Information More Conventional Plan details More Premier Plan details More Premier Plan Plus details

Ready to Enroll for 2019?

If you’re ready to take the next step and begin enrolling, find out how easy it is.
H3811_MA4001-2_2019a, Page updated 11/24/2018