2023 Select (LPPO) Plan
IMPORTANT NOTICE ABOUT TERMINATING PLAN: The Generations Advantage Select (LPPO) H1365-004-001 plan is ending on December 31, 2023 in the following counties: MAINE-Aroostook, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, and Washington; NEW HAMPSHIRE: Coos. All current Select plan members in these counties MUST take action now or your coverage will revert to Original Medicare on January 1, 2024. Please call 1-877-547-7053 (TTY:711)
Generations Advantage Select (LPPO) is designed for those looking for a health plan with more flexibility.
With this plan, you get complete medical, hospital, and Part D Prescription Drug coverage and you can see out-of-network providers for all covered medical services, though you pay less for in-network providers.
The Select plan is available throughout Maine and New Hampshire.
Your Area
Costs
- Please enter your ZIP Code above to see your plan premium.
Plan Benefits
- Doctor and hospital visits with no deductibles
- Part D Prescription Drug coverage (see if your drugs are covered)
- Eyewear and contact lens reimbursement
- Hearing aids
- Over-the-counter (OTC) items
- Wellness Wallet reimbursements
- Coverage while you travel with worldwide urgent and emergency care
- Large network of doctors across Maine and New Hampshire (see if your doctor is in-network)
- Out-of-network flexibility: Option of getting all covered services outside the network, but you will generally pay more for these services2
- Flu shots: Get your annual flu shot3 at no cost, either at your primary care provider’s office (who may charge an office visit copay) or a participating pharmacy.4
*NOTE: This is not a comprehensive list of plan benefits, please refer to the Evidence of Coverage (EOC) for a full list of plan benefits.
Part D Prescription Drug Copayments
*For 90-day supply cost, multiply by three.
**Varies by County: Aroostook, Hancock, Kennebec, Penobscot, Piscataquis, Somerset, and Washington Counties in Maine and Coos, Belknap, Carroll, and Grafton in New Hampshire. There is a $275 prescription deductible for Tiers 3–5 drugs only. For Tiers 3, 4 and 5, you pay the full cost of the drug until you reach your $275 deductible. Tier 5 cost is 28%.
Androscoggin, Cumberland, Franklin, Knox, Lincoln, Oxford, Sagadahoc, Waldo, and York Counties in Maine and Cheshire, Hillsborough, Merrimack, Rockingham, Strafford, and Sullivan Counties in New Hampshire, there is no prescription deductible and Tier 5 cost is 33%.
LEARN MORE, ENROLL NOW!
Request your Medicare Guide to learn more about our plans and discover how a Generations Advantage plan can help you live your best life.
1At pharmacies with preferred cost-sharing, you pay $0 for Cost-Sharing Tier 1
(preferred generic drugs and certain preferred brand name drugs). Other pharmacies are available in our network.
2Out-of-network/non-contracted providers are under no obligation to treat Select plan members, except in emergency situations. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre service organization determination before you receive the service. 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.
3Influenza (flu) vaccines are covered under your Medicare Part B benefit through Generations Advantage Select and costs do not count toward your Part D drug spend or out-of-pocket costs.
4The Vaccine Pharmacy Network is offered through our relationship with our pharmacy benefit manager, CVS Caremark. Pharmacy network may change on January 1 of each year. Other pharmacies are available in our network.
You may download Adobe Reader free to view the PDF documents.
The materials on this page may be made available in other formats such as Braille, large print or other alternate formats. Please contact us for more information. Call Member Services at 1-866-544-7504 (TTY:711).
View Disclaimers