2022 Select (LPPO) Plan

Generations Advantage Select (LPPO) 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 doctors. The Select plan is available throughout Maine and New Hampshire.

Your Area

Select 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 for 2022)
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
Over-the-counter (OTC): Up to $50 quarterly for members to purchase select CVS-brand, over-the-counter products
Wellness Wallet: Up to $200 reimbursed each year in total for eyewear, face masks, fitness, 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 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

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.

What makes a 5 Star Medicare Plan?

Martin's Point has plans that have received the highest possible ratings from the government agency that administers Medicare. Our quality and performance across healthcare and customer experience are top-notch!

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 $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.

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