Costs
My mom lives in Yuma county. What is the monthly premium for Banner Medicare Advantage Prime?
Unfortunately our plan is not available in Yuma county.
Is a referral required for outpatient transfusion?
Yes - A referral is required for outpatient transfusion
Do you have a summary of your plan benefits on your website?
Yes, the summary of benefits is located on our website.
Does my Mom have to pay for a flu shot?
No, there is no cost for a flu shot.
What is the star rating for Banner Medicare Advantage Prime?
Our plan is too new to be measured.
My mom, who lives in Pinal county, does not get extra help and is not on Medicaid. What is the monthly consolidated premium for Banner Medicare Advantage Plus?
The monthly consolidated premium would be a $40.00 monthly premium.
*This would not include any OSB option.
If my mom enrolls in Banner Medicare Advantage Prime will she be covered if she goes to an out-of-network doctor for routine care?
For our Prime Plan must use an in-network doctor for routine care, care from an out-of-network provider will not be covered.
Is a list of covered drugs on your plan's website?
Yes, a list of covered drugs is provided on our website. This is also called a formulary.
If my mom joins your plan, and one of her medications is not covered by your plan, can she get a temporary supply of her medicine at the beginning of her enrollment in the plan?
Yes, we will cover a temporary supply of your drug during the first 90 days of her membership. Temporary supply will be for a maximum of 31 days.
Where can my mom find the plan's privacy notice?
Your mom can find our privacy notice on our website, www.bannerma.com
What is the annual drug deductible for Banner Medicare Advantage Prime?
The annual drug deductible is $150.00
My mom is a smoker and is trying to quit. Will Banner Medicare Advantage provide counselling to help her quit smoking?
Yes the plan provides counselling for smoking cessation.
If my mom enrolls in your plan, do you have a form she can fill out to make me her representative?
Yes, we have a link available online to an Appointment of Representative form. We can also provide a copy via mail.
Is Xenical a covered medication for Banner Medicare Advantage Plus?
No, Xenical is not a covered medication
Will you let my mom know if her primary doctor leaves the plan?
Yes, we will notify members when a provider leaves our plan (or network). We try to notify you at least 30 days' notice that her provider is leaving our plan so that you have time to select a new provider.
Will joining Banner Medicare Advantage Prime affect how much my mom pays for her Part B premium?
No, joining the plan will not affect how much is paid for a Part B Premium
If my mom goes to the emergency room, will the co-payment be waived if she is admitted to the hospital within a certain amount of time?
Yes, the co-payment is waived if she admitted to the hospital within 24 hours.
My mom is blind; can she get an audio version of your summary of benefits?
My mom is blind; can she get an audio version of your summary of benefits?
Would my mom need prior authorization to get Dovato?
Prior Authorization is not required for Dovato.
If my mom enrolls in your plan, does she have the option to go back to original Medicare during next year's open enrollment period?
Yes, she will have the option to go back to original Medicare.
My mom is currently required to pay an extra amount for prescription drug coverage because of her income. If she enrolls in your plan, can she just add it to the
plan's monthly premium payment?
An extra amount for prescription drug coverage due to her income cannot be paid with her monthly plan premium.
How many days does your plan cover for care at a Skilled Nursing Facility?
Our plan covers up to 100 days in a skilled nursing facility.
Where is the AOR located on the website?
Resources, Grievance and Appeals
My mom thinks it is cheaper to buy some of her prescriptions at Walmart and pay $4.00 for a generic drug instead of using her insurance. If she enrolls in your plan, does she have to show her plan card and buy her drugs through your plan or can she continue to pay for drugs on her own?
She does not have to show her plan card and she can continue to pay for drugs on her own. Although if she does not show her card her costs may not count toward her overall drug plan expense.
Can my mom use her Medicare supplement insurance to pay for Medicare Advantage plan's out-of-pocket costs, like co-pays?
Unfortunately Medicare supplement insurance only work with the original Medicare plan and will is unable to be used with our Medicare Advantage Plan.