Zing Choice IL (HMO)

Zing Choice IL (HMO) H7330-001 Plan Details
Plan too new to be measured

Zing Choice IL (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna.
Plan ID: H7330-001.

$0.00
Monthly Premium

Zing Choice IL (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna.
Plan ID: H7330-001.

Zing Choice IL (HMO) H7330-001 Plan Details
Plan too new to be measured

Zing Choice IL (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Aetna.
Plan ID: H7330-001.

$0.00
Monthly Premium

Illinois Counties Served

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $3450
Out-of-Network: N/A
Initial Coverage Limit $4430
Catastrophic Coverage Limit $7,050
Primary Care Doctor Visit
In-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0.00


Telehealth:

  • $0 copay per telehealth visit
  • You can access board certified doctors and behavioral health specialist via phone and/or video technology for diagnosis and treatment of certain non emergency medical conditions.
  • Doctors can diagnose and prescribe medications if medically necessary.
  • Please call us for more details.
Specialty Doctor Visit
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $25.00
Inpatient Hospital Care
In-Network:
Acute Hospital Services:
$250.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
After day 90, your plan covers an unlimited number of days for an inpatient hospital stay.
Prior Authorization Required for Acute Hospital Services
Prior authorization required
Urgent Care
Copayment for Urgent Care $10.00
Emergency Room Visit
Copayment for Emergency Care $120.00
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $0.00
Ambulance Transportation
In-Network:
Ground Ambulance:
Copayment for Ground Ambulance Services $175.00 per date of service
Air Ambulance:
Coinsurance for Air Ambulance Services 20%

Please see Evidence of Coverage for Prior Authorization rules
Prior authorization required

Health Care Services and Medical Supplies

Zing Choice IL (HMO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In-Network: Copayment for Medicare-covered Chiropractic Services $20.00
Manual manipulation of the spine to correct subluxation (when one or more of the bones of your spine move out of position).
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network:
  • $0 copay for preferred diabetic test strips and monitoring supplies
  • 20% coinsurance for nonpreferred diabetic test strips and monitoring supplies
  • $0 copay for diabetes selfmanagement training
  • 20% coinsurance for therapeutic shoes or shoe inserts
Durable Medical Eqipment (DME)
In-Network:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Prior Authorization Required for Durable Medical Equipment
This Plan has preferred Vendors/Manufacturers - Please see Evidence of Coverage
Prior authorization required
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $25.00
Copayment for Medicare-covered Lab Services $0.00

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $50 to $150. Copayment may vary depending on the place of service.
Coinsurance for Medicare-covered Therapeutic Radiological Services 20%
Copayment for Medicare-covered X-Ray Services $0.00
Prior Authorization Required for Outpatient Diag/Therapeutic Rad Services

If a member receives multiple services on the same day at the same location, only the maximum copay applies.
Prior authorization required
Home Health Care
In-Network:
Copayment for Medicare-covered Home Health Services $0.00
Prior Authorization Required for Home Health Services
Prior authorization required
Mental Health Inpatient Care
In-Network:
Psychiatric Hospital Services:
$250.00 per day for days 1 to 6
$0.00 per day for days 7 to 90
Your plan covers up to 190 days in a lifetime for inpatient mental health care in a
psychiatric hospital.
Prior Authorization Required for Psychiatric Hospital Services
Prior authorization required
Mental Health Outpatient Care
In-Network:
Copayment for Medicare-covered Individual Sessions $25.00
Copayment for Medicare-covered Group Sessions $25.00
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $300.00
Prior Authorization Required for Outpatient Hospital Services

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $150.00

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $200.00
Prior Authorization Required for Ambulatory Surgical Center Services
Prior authorization required
Outpatient Substance Abuse Care
In-Network:
Copayment for Medicare-covered Individual Sessions $25.00 per visit
Copayment for Medicare-covered Group Sessions $25.00 per visit
Opioid Treatment Services $25.00 per visit
Prior Authorization May Be Required for Outpatient Substance Abuse Services
Prior authorization required
Over-the-counter (OTC) Items
In-Network:

Over-The-Counter (OTC) Items:
  • Copayment for Over-The-Counter (OTC) Items $0.00
  • Maximum Plan Benefit of $75.00 every three months
  • The OTC benefit includes nicotine replacement therapy (NRT).
  • The OTC debit card allows members to purchase health related items from retail pharmacies as well as mail order purchases.
  • If you do not use all your quarterly OTC benefit amount when you order, the remaining balance will not accumulate to the next OTC benefit period.


You can order:

  • Online  visit NationsOTC.com/ZingHealth
  • By Phone  call a NationsOTC Member Experience Advisor at 1-877-273-3381 (TTY: 711), 24 hours a day, seven days a week, 365 days a year.
  • By Mail  Fill out and return the order form in the NationsOTC/Zing Health product catalog.
  • Retail  through an approved, in network retailer
Podiatry Services
In-Network:
Copayment for Medicare-Covered Podiatry Services $25.00 per visit
Copayment for Routine Foot Care $20.00 per visit
  • Maximum 4 visits every year
Skilled Nursing Facility Care
In-Network:

Skilled Nursing Facility Services:
$0.00 per day for days 1 to 20
$188.00 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services
Prior authorization required

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
In-Network:

Preventive Dental:
  • $0 copay for oral exams up to one (1) every six (6) months
  • $0 copay for prophylaxis (cleaning) up to one (1) every six (6) months
  • $0 copay for a fluoride treatment for up to one (1) every year
  • $0 copay for bitewing x-rays up to one (1) set per year
  • $0 copay for panoramic x-rays for up to one (1) every five (5) years
Maximum Plan Benefit of $2,500 benefit allowance every year for preventive and comprehensive dental benefits combined.
You are responsible for all cost beyond the maximum allowed amount.
Not covered out-of-network
Comprehensive Dental:
  • $0 copay for amalgam and/or composite filling every three (3) years per tooth
  • $0 copay for extractions one (1) extraction per tooth, per year
  • $0 copay for root canals one (1) per lifetime, per tooth
  • $0 copay for scaling/root planning (deep cleaning) every (24) months per quadrant
  • $0 copay for complete crown every five (5) years, per tooth
  • $0 copay for dentures or fixed prosthetics/partials once every five (5) years
Maximum Plan Benefit of $2,500 benefit allowance every year for preventive and comprehensive dental benefits combined.
You are responsible for all cost beyond the maximum allowed amount.
Not covered out-of-network

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In-Network:

Eye Exams:
Copayment for Medicare Covered Benefits $25.00
Copayment for Routine Eye Exams $0.00
  • Maximum 1 Routine Eye Exam every year
Maximum Plan Benefit of $290.00 every year for Eye Exams and Eyewear combined

Eyewear:
Copayment for Medicare-Covered Benefits $0.00
Copayment for Contact Lenses $0.00
  • Maximum 1 Pair every year
Copayment for Eyeglasses (lenses and frames) $0.00
  • Maximum 1 Pair every year
Copayment for Eyeglass Lenses $0.00
  • Maximum 1 Pair every year
Copayment for Eyeglass Frames $0.00
  • Maximum 1 Pair every year

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $25.00
Copayment for Routine Hearing Exams $0.00
  • Maximum 1 visit every year
Copayment for Fitting/Evaluation for Hearing Aid $0.00
  • Maximum 1 visit every three years

Hearing Aids:
Copayment for Hearing Aids - Inner Ear $0.00
  • Maximum 2 Hearing Aids - Inner Ear every three years
Copayment for Hearing Aids - Outer Ear $0.00
  • Maximum 2 Hearing Aids - Outer Ear every three years
Copayment for Hearing Aids - Over the Ear $0.00
  • Maximum 2 Hearing Aids - Over the Ear every three years
Maximum Plan Benefit of $750.00 every three years per ear
"Access to a nationwide network of 4,000+ providers

"Hearing aids available from all major brands

"Concierge services by dedicated Member Experience Advisors

"Three follow-up visits

"3-year repair warranty

"3 years of batteries included

"One-time replacement coverage for lost, stolen or damaged hearing aids -In the event a Hearing Aid is lost stolen or damaged, the member pays a deductible ($175-$225) depending on the specific manufacturer of the hearing aid in question.

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation
    Yearly "Wellness" visit