2023 Plan Benefits | LEON MediExtra (HMO) | ||
---|---|---|---|
Prescription Drugs | |||
Initial Coverage Limit (ICL) | $9,000 | ||
Dental | |||
Comprehensive and Preventive Maximum Benefits | $5,000 | ||
Vision | |||
Eyewear Lenses and Frames | $500 maximum benefit (up to 3 pairs) | ||
Contact lenses | $210 maximum benefit (up to 6 boxes of soft lenses/$35 per box) | ||
Hearing Services | |||
Hearing Aids | $2,100 maximum benefit / 3 years ($1,050 per hearing aid per ear) | ||
Drugs/OTC | |||
OTC | $840 annual | ||
LeonPlus | With the flexibility to choose from different options | ||
Part B Premium Give Back | |||
Part B Premium Reduction | not applicable | ||
Acupuncture | |||
Routine | $0 for 6 visits | ||
Medical | |||
PCP Visit | $0 | ||
Inpatient Hospital (per admission) | $0 | ||
Lab Services and X-Rays | $0 |
2023 Plan Benefits |
---|
LEON MediExtra (HMO) |
Prescription Drugs |
Initial Coverage Limit (ICL) |
$9,000 |
Dental |
Comprehensive and Preventive Maximum Benefits |
$5,000 |
Vision |
Eyewear Lenses and Frames |
$500 maximum benefit (up to 3 pairs) |
Contact lenses |
$210 maximum benefit (up to 6 boxes of soft lenses/$35 per box) |
Hearing Services |
Hearing Aids |
$2,100 maximum benefit / 3 years ($1,050 per hearing aid per ear) |
Drugs/OTC |
OTC |
$840 annual |
LeonPlus |
With the flexibility to choose from different options |
Part B Premium Give Back |
Part B Premium Reduction |
not applicable |
Acupuncture |
Routine |
$0 for 6 visits |
Medical |
PCP Visit |
$0 |
Inpatient Hospital (per admission) |
$0 |
Lab Services and X-Rays |
$0 |

2023 Membership Benefits
This comprehensive plan provides an Initial Coverage limit of $9,000 for Prescription Drugs, and great supplemental benefits.