2023 Focus DC (HMO SNP) Plan

This is of the few plans in the country to receive 5 stars from Medicare, earning Medicare’s highest quality rating!

Generations Advantage Focus DC (HMO SNP) offers complete medical, hospital, and Part D Prescription Drug coverage, with focused care and benefits for people living with diabetes in Cumberland County.1 All benefits are for in-network services only, except urgent and emergency care.

Your Area

Focus DC 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 with no deductibles (see if your drugs are covered)
  • Worldwide urgent and emergency care
  • Large network of doctors across Maine and New Hampshire (see if your doctor is in-network)
  • Eyewear: $150 for prescription lenses, frames, and contact lenses
  • Over-the-counter (OTC): Up to $90 quarterly ($360 each year in total) for members to purchase select CVS-brand, over-the-counter products
  • Wellness Wallet: Up to $300 reimbursed each year in total for fitness/wellness gear and services, face masks, naturopathic services, acupuncture, nutritional/dietary education, 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 shot benefit: 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
  • See a dentist in the Delta Dental network.
  • Diagnostic and preventive services are fully covered with no coinsurance or deductible (includes cleaning, exams, and X-rays).
  • Basic restorative services are covered with 50% coinsurance and a one-time $50 deductible (includes amalgam (silver) fillings, oral surgery, root canals, and periodontal maintenance).
  • Major restorative services are covered with 50% coinsurance and a one-time $50 deductible (includes dentures, bridges, crowns, onlays, and implants).

 

Time is running out. Open enrollment ends December 7!
Enroll Now for 2023
Have questions? We’re here to help.

Talk to a health plan specialist 8 am–8 pm, Monday - Friday.

Enroll:
1-800-603-0652 
(TTY: 711)

Current Members:
1-866-544-7504

2023 Plan Details and Documents
Additional Resources

Part D Prescription Drug Copayments

Tier 1 2 3 4 5
Pharmacies with preferred cost sharing (including Hannaford pharmacies), 30-day supply* $0 $10 $40 $95 33% of cost
Pharmacies with Standard cost sharing, 30-day supply* $4 $18 $47 $100 33% of cost
Mail-order, 90-day supply $10 $45 $117.50 $250 33% of cost
*For 90-day supply cost, multiply by three.

Medicare Pre-Enroll Guide Image

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.

1This plan is available (in Cumberland County only) to anyone with Medicare who has been diagnosed with diabetes by a doctor or other licensed professional.

2At 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.

3Influenza (flu) vaccines are covered under your Medicare Part B benefit through Generations Advantage Focus DC 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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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).


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