You trust Aspirus for your care. Now you can trust Aspirus Health Plan for your Medicare coverage. We offer all the benefits you need without leaving the network you know.
Need help? Call 715-631-7437 (TTY users call 1-855-931-4855) 8 am – 5 pm, Monday – Friday.
You want care for the whole you, from head to toe. Our Medicare Advantage plans help you
get it, without breaking your budget.
Choose a $0 premium plan and pay a little more for care if you need it. Or choose our low
premium plan and save on out-of-pocket costs when you need care.
Learn the basics of Medicare, including the 4 parts of Medicare, what they cover, when to enroll, and how to enroll.
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Are your drugs covered?
Formulary (list of covered drugs)
Learn about our 2021 Plans
Summary of benefits
*You must continue to pay your Part B premium
Primary: $0 copay
Specialist: $45 copay
In-network: $5,900
Out-of-network combined with in-network: $6,500
$0 copay for many services
$350 copay per day (days 1–5); then
100% covered
$395 copay
$90 copay
Includes routine dental with optional coverage available
$0 copay
30% of the cost of services
$50 semiannually
Includes basic health
club membership
Annual deductible:
Tier 1 & 2 = $0
Tiers 3–5 = $295
Copays based on drug tiers, as low as $3
$0 copay for routine eye exam
$45 copay for diagnostic eye exam
$100 eyewear/contacts allowance
Copays shown at preferred pharmacy rates^
$3 copay
$0 copay for routine hearing exam
$45 copay for diagnostic hearing exam
$699 per Advanced Hearing Aid
$999 per Premium Hearing Aid
^Aspirus Health Plan preferred pharmacies offer lower cost sharing.
*You must continue to pay your Part B premium
Primary: $0 copay
Specialist: $40 copay
In-network: $4,000
Out-of-network combined with in-network: $4,500
$0 copay for many services
$300 copay per stay; then 100% covered
$295 copay
$90 copay
Includes routine dental with optional coverage available
$0 copay
30% of the cost of services
$50 semiannually
Includes basic health
club membership
Annual deductible:
Tier 1 & 2 = $0
Tiers 3–5 = $295
Copays based on drug tiers, as low as $2
$0 copay for routine eye exam
$40 copay for diagnostic eye exam
$175 eyewear/contacts allowance
Copays shown at preferred pharmacy rates^
$2 copay
$0 copay for routine hearing exam
$40 copay for diagnostic hearing exam
$599 per Advanced Hearing Aid
$899 per Premium Hearing Aid
^Aspirus Health Plan preferred pharmacies offer lower cost sharing.
*You must continue to pay your Part B premium
Primary: $0 copay
Specialist: $40 copay
In-network: $4,000
Out-of-network combined with in-network: $4,500
$0 copay for many services
$300 copay stay; then 100% covered
$295 copay
$90 copay
Includes routine dental with optional coverage available
$0 copay
30% of the cost of services
$50 semiannually
Includes basic health club membership
Not covered
$0 copay for routine eye exam
$40 copay for diagnostic eye exam
$175 eyewear/contacts allowance
Not covered
$0 copay for routine hearing exam
$40 copay for diagnostic hearing exam
$599 per Advanced Hearing Aid
$899 per Premium Hearing Aid
Aspirus Health Plan, Inc. is a PPO plan with a Medicare contract. Enrollment in Aspirus Health Plan, Inc. depends on contract renewal.
H6874_50261_2121
10/2020
