Plan Benefit Comparison
Below are overviews of the three exclusive medical and drug plan options available to Medicare-eligible member retirees. These benefits are effective June 1 – December 31, 2024. Once you have had a chance to compare and choose an option that works best for you — or if you have questions — please give us a call at (855) 855-6942.
For a list of in-network Humana providers, click here
For a list of in-network Humana pharmacies, click here
For a full list of covered drugs, click here
MEDICARE ADVANTAGE SILVER PPO
2024 MONTHLY PREMIUM
$38.85
MEDICAL BENEFITS
Maximum Out‐of‐Pocket
$7,500
Deductible
$0
Inpatient Hospital
$295 (days 1‐7)
Primary Care Physician (PCP) Visit
$10
Specialist Visit
$55
Surgery
$300
Emergency Room
$100
Non‐Medicare Covered Services
Hearing, Vision, Dental, Podiatry, Routine Chiropractic
RX BENEFITS
Formulary Type
Group Plus 5 Tier (Open)
Deductible
$200
30 Day Retail / Mail
$7 / $8 / $30 / $80 / 30%
Gap Coverage
$7 / $8 / 25% / 25% / 25%
Click here for full 2024 Silver plan details.
2025 plan details and pricing expected fall of 2024.
MEDICARE ADVANTAGE GOLD PPO
2024 MONTHLY PREMIUM
$111.27
MEDICAL BENEFITS
Maximum Out‐of‐Pocket
$6,000
Deductible
$0
Inpatient Hospital
$225 (days 1‐7)
Primary Care Physician (PCP) Visit
$5
Specialist Visit
$55
Surgery
$180
Emergency Room
$100
Non‐Medicare Covered Services
Hearing, Vision, Dental, Podiatry, Routine Chiropractic
RX BENEFITS
Formulary Type
Group Plus 5 Tier (Open)
Deductible
$200
30 Day Retail / Mail
$4 / $5 / $20 / $100 /30%
Gap Coverage
$4 / $5 / 25% / 25% / 25%
Click here for full 2024 Gold plan details.
2025 plan details and pricing expected fall of 2024.
MEDICARE ADVANTAGE PLATINUM PPO
2024 MONTHLY PREMIUM
$164.35
MEDICAL BENEFITS
Maximum Out‐of‐Pocket
$4,000
Deductible
$0
Inpatient Hospital
$150 (days 1‐7)
Primary Care Physician (PCP) Visit
$0
Specialist Visit
$20
Surgery
$125
Emergency Room
$100
Non‐Medicare Covered Services
Hearing, Vision, Dental, Podiatry, Routine Chiropractic, OTC, Transportation, Wigs
RX BENEFITS
Formulary Type
Group Plus 5 Tier (Open)
Deductible
$0
30 Day Retail / Mail
$4 / $5 / $10 / $25 / 30%
Gap Coverage
$4 / $5 / 25% / 25% / 25%
Click here for full 2024 Platinum plan details.
2025 plan details and pricing expected fall of 2024.
We’re here for you every step of the way
EASY PHONE ENROLLMENT & SUPPORT
Our concierge customer support team is available to answer questions, help you enroll in a plan, and provide support post-enrollment.
NO WAIT TO ENROLL
Since PROMISE is a new product available to union retirees, you can enroll at any time of the year — not just during the Annual Enrollment Period (AEP).