2022 Flex (RPPO) Plan

This Medicare Plan Is Being Discontinued

IF YOU ENROLL IN THE FLEX PLAN, YOU MUST ENROLL IN A NEW 2023 PLAN or your coverage will switch to Original Medicare on January 1, 2023.

Generations Advantage Flex (RPPO) is designed for those looking for a health care 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 doctors for all covered medical services, though you pay less for in-network and in-service-area doctors. The Flex plan is available throughout the service area of Maine and New Hampshire.

Your Area

Flex Benefits

Costs

Please enter your Zip Code above to see your plan premium.

*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.

Features

Part D Prescription Drug coverage (see if your drugs are covered for 2022)
Emergency and Urgent care coverage worldwide
Large network of doctors across Maine and New Hampshire (see if your doctor is in-network)
Out-of-network flexibility: option of getting all services outside the network, but you will generally pay more for these services²
Over-the-counter (OTC): Up to $50 quarterly for members to purchase select CVS-brand, over-the-counter items
Wellness Wallet: Up to $200 reimbursed each year in total for eyewear, face masks, dietary/nutrition, fitness benefit, naturopathic services, acupuncture, and weight management programs (see what's covered)
Hearing aids: $495/$695/$1,095/$1,495/$2,095 copay per ear, depending on tier selected (no copays for fittings or evaluations)
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

Comprehensive Dental Benefits

No waiting periods for coverage
$50 office visit copay
$1,000 benefit maximum (in- and out-of-network combined)
In-Network: See a dentist in the Delta Dental network.
Out-of-Network: See any out-of-network dentist, cost shares differ.
Diagnostic and preventive services include cleanings, exams, and X-rays: In-network—fully covered with no coinsurance/deductible; Out-of-network—covered at 50% with no deductible.
Basic restorative services include fillings, oral surgery, root canals, and periodontal maintenance: In-network—covered with 50% coinsurance and a one-time $50 deductible; Out-of-network—covered with 75% coinsurance and a one-time $50 deductible.
Major restorative services include dentures, bridges, crowns, onlays, and implants: In-network—covered with 50% coinsurance and a one-time $50 deductible; Out-of-network—covered at 75% coinsurance and a one-time $50 deductible.

Part D Prescription Drug Copayments

$275 Prescription deductible for Tiers 3–5 drugs only

Tier	1	2	3	4	5
Pharmacies with preferred cost sharing (including Hannaford pharmacies), 30-day supply*	$2	$10	$40	$95	28% of cost
Pharmacies with Standard cost sharing, 30-day supply*	$4	$18	$47	$100	28% of cost
Mail-order, 90-day supply	$0	$20	$100	$237.50	28% of cost

*For 90-day supply cost, multiply by three.

Open Enrollment Begins October 15

Request your 2022 Medicare Guide to learn more about our plans and discover how a Generations Advantage plan can help you live your best life.

Request your 2022 Guide

¹At pharmacies with preferred cost-sharing, you pay $2 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 Flex 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 Flex 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.

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