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Prescription Drug Plan Costs & Benefits

Welcome to Senior Whole Health

Senior Whole Health of New York NHC includes an basic benefit Medicare Part D plan . This simply means that the plan covers the minimum amount required by the Centers for Medicare & Medicaid ServicesThe Centers for Medicare & Medicaid Services is the U.S. Federal agency that runs the Medicare, Medicaid, and Childrens Health Insurance Programs., whereas enhanced benefit plans cover more.

Basic plans typically have less cost-sharing by the plan than plans with an enhanced benefit. But, close to a third of all enhanced plans charge more than the average for preferred brand name drugs, and over 50% charge more for non-preferred brand drugs. For most people, a basic plan is their best bet, due to lower premiums and lower cost-sharing, even if the plan has a deductible.

Prescription Drug Plan Premium

Although the prescription drug plan premium is bundled with the total plan cost, some plans have supplemental costs and/or offer low-income subsidySocial Security’s Low-Income Subsidy program helps Medicare beneficiaries pay for their Medicare Part D prescription drugs by paying some of the costs. Also known as “Extra Help”, beneficiaries who qualify for LIS receive premium… assistance. The following table outlines the prescription drug plan premium details of this plan.

Basic Part D Premium:
Part D Premium with 25% LIS Assistance: $29.20

For more information about the Low-Income Subsidy program, refer to the Social Security Extra Help page.

Senior Whole Health Information Center

HHAeXchange & Senior Whole Health of New York, a Molina Company Partnership

Senior Whole Health of New York, a Molina Company, has partnered with HHAeXchange to leverage our platform to implement Electronic Visit Verification for Personal Care services. As part of the approach for the 21st Century Cures Act, Senior Whole Health of New York, a Molina Company, has elected to have HHAeXchange transmit EVV data via a web interface to eMedNY on behalf of the network providers.

Through the HHAX platform we will be able to electronically send new home health aide cases to you, manage authorizations, confirm visits using EVV, and most importantly send all communications in real-time.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to Senior Whole Health of New York, a Molina Company for:

  • Electronic case broadcasting, authorizations, plan of care management and entering confirmed visits

  • Real-time two-way communications and messaging with Senior Whole Health of New York, a Molina Company

  • Free EVV solution for time & attendance and duty tracking

  • Electronic billing along with pre-billing review

Your Agencys Options & Onboarding Process:

Enterprise Agencies currently using HHAeXchange: You currently pay for the HHAeXchange Full Enterprise platform. With Senior Whole Health of New York, you will be able to continue using HHAeXchange, utilizing the systems enhanced Linked Contract functionality.

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Senior Whole Health Reviews Faqs

Senior Whole Health has an overall rating of 3.0 out of 5, based on over 42 reviews left anonymously by employees. 46% of employees would recommend working at Senior Whole Health to a friend and 39% have a positive outlook for the business. This rating has been stable over the past 12 months.

According to anonymously submitted Glassdoor reviews, Senior Whole Health employees rate their compensation and benefits as 3.2 out of 5. Find out more about salaries and benefits at Senior Whole Health. This rating has decreased by -3% over the last 12 months.

46% of Senior Whole Health employees would recommend working there to a friend based on Glassdoor reviews. Employees also rated Senior Whole Health 3.1 out of 5 for work life balance, 2.7 for culture and values and 2.8 for career opportunities.

According to reviews on Glassdoor, employees commonly mention the pros of working at Senior Whole Health to be culture, career development, coworkers and the cons to be senior leadership, management, benefits.

How To Qualify To Enroll In Senior Whole Health Of New York Nhc

Senior Citizen Health Package for Individual @ Home

To qualify for enrollment in Senior Whole Health of New York NHC in County, you must be eligible for both Medicare and Medicaid. To be eligible for Medicare, you must be age 65 or older, or have Social Security Disability Insurance for 24 months. To be eligible for Medicaid, your income and assets must be at or below ‘s state thresholds.

Before enrolling in Senior Whole Health of New York NHC, or any other dual-eligible SNP, be sure to ask the following questions:

  • What costs should I expect to pay out-of-pocket ?
  • Will I be able to use my doctors? Are they in the plan’s network?
  • Are the plan’s in-network providers and facilities in convenient locations?
  • Does the plan provide coverage for services I receive from out-of-network providers?
  • Do I need a referral to see a specialist?
  • Are my medications on the Part D plan’s formularyA formulary is a list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Medications not on a plan’s formulary are generally not covered.? What if I can’t afford my medications?
  • What special accommodations does the plan make for persons with disabilities?
  • Does the plan offer free meal delivery after a stay in the hospital?
  • What help is offered for caregivers? Is adult day care covered?
  • Does the plan offer a prepaid card for over the counter medications and covered groceries?

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Senior Whole Health Of New York Nhc 2023 Medicare Advantage Special Needs Plan Review

Senior Whole Health of New York NHC is a D-SNP Medicare Advantage Special Needs Plan from Senior Whole Health of New York. It offers all of the same basic benefits as Original MedicareOriginal Medicare is private fee-for-service health insurance for people on Medicare. It has two parts. Part A is hospital coverage. Part B is medical coverage., plus some additional benefits that Medicare Part AMedicare Part A is hospital coverage for Medicare beneficiaries. It covers inpatient care in hospitals and skilled nursing facilities. It also covers limited home healthcare services and hospice care. and Part B do not cover, but out-of-pocket costsOut-of-Pocket Costs for Medicare are the remaining costs that are not covered by the beneficiary’s health insurance plan. These costs can come from the beneficiary’s monthly premiums, deductibles, coinsurance, and copayments. are different.

This plan has not been rated by CMS.

Cms Rating Marks And Our Review

Each year Medicare rates D-SNP plans, like this one, in nine major categories. These ratings are designed to help you understand the quality of care and service you can expect if you qualify and choose to join Senior Whole Health of New York NHC.

Although Senior Whole Health of New York NHC is too new to have a Medicare star rating, we can offer some input on its value.At this time, we do not have enough information to rate how well Senior Whole Health of New York NHC does at keeping its members healthy. We do not have enough information to rate how well this plan manages long-term health conditions. We do not have enough information from this plan to rate member experience. We do not have enough information from this plan to rate complaints and plan performance changes.

CMS Measure

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Health Plan Costs & Benefits

Senior Whole Health of New York NHC is a Health Maintenance Organization plan. HMO plan members usually receive health care services through the plans local network of providers. Referrals are almost always required to see a specialist and other providers. However, Senior Whole Health of New York NHC does allow out-of-network care for emergencies and out-of-area dialysis.

PremiumsA premium is an amount that an insurance policyholder must pay for coverage. Premiums are typically paid on a monthly basis. In the federal Medicare program, there are four different types of premiums. , deductiblesA deductible is an amount a beneficiary must pay for their health care expenses before the health insurance policy begins to pay its share., and copays vary widely from plan to plan. It is very important to compare costs and apply them to your personal financial and healthcare needs.

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