| 2027 Plan Benefits | Leon MediDual (HMO D-SNP) | ||
|---|---|---|---|
| Prescription Drugs | |||
| Initial Coverage Phase | $2,400 | ||
| Dental | |||
| Preventive and Comprehensive Maximum Benefit | $5,050 | ||
| Vision | |||
| Eyewear Lenses and Frames | $525 maximum benefit
(up to 3 pairs each year) | ||
| Hearing Services | |||
| Hearing Aids | $2,100 maximum benefit / 3 years ($1,050 per hearing aid, per ear) | ||
| Leon Card + OTC | |||
| Maximum Annual Benefit | $2,400*
*If you don’t have a qualifying chronic condition and meet the plan’s eligibility criteria, you can still use your allowance for eligible OTC items at LMC pharmacies or approved retail locations. | ||
| Part B Premium Give Back | |||
| Part B Premium Reduction | not applicable | ||
| Acupuncture | |||
| Routine | $0 for up to 25 visits | ||
| Medical | |||
| PCP Visit | $0 | ||
| Inpatient Hospital (per admission) | $0 | ||
| Lab Services and X-Rays | $0 | ||
| 2027 Plan Benefits |
|---|
| Leon MediDual (HMO D-SNP) |
| Prescription Drugs |
| Initial Coverage Phase |
| $2,400 |
| Dental |
| Preventive and Comprehensive Maximum Benefit |
| $5,050 |
| Vision |
| Eyewear Lenses and Frames |
| $525 maximum benefit
(up to 3 pairs each year) |
| Hearing Services |
| Hearing Aids |
| $2,100 maximum benefit / 3 years ($1,050 per hearing aid, per ear) |
| Leon Card + OTC |
| Maximum Annual Benefit |
| $2,400*
*If you don’t have a qualifying chronic condition and meet the plan’s eligibility criteria, you can still use your allowance for eligible OTC items at LMC pharmacies or approved retail locations. |
| Part B Premium Give Back |
| Part B Premium Reduction |
| not applicable |
| Acupuncture |
| Routine |
| $0 for up to 25 visits |
| Medical |
| PCP Visit |
| $0 |
| Inpatient Hospital (per admission) |
| $0 |
| Lab Services and X-Rays |
| $0 |
