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Longevity Health Plan (PPO I-SNP)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Longevity Health Plan (PPO I-SNP). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Longevity Health Plan (PPO I-SNP) in 2025, please refer to our full plan details page.
Longevity Health Plan (PPO I-SNP) is a PPO I-SNP plan offered by Longevity Health Founders, LLC available for enrollment in 2025 to people living in New Jersey (partial). This plan received an overall rating of 4.5 out of 5 stars in 2025.
It's important to know that Longevity Health Plan (PPO I-SNP) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Longevity Health Plan (PPO I-SNP)is a Special Needs Type (SNP) plan. This means you can only enroll in this plan if you meet specific criteria. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Longevity Health Plan (PPO I-SNP).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Longevity Health Plan (PPO I-SNP), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $56.90. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $14000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $14000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Longevity Health Plan (PPO I-SNP) has a prescription drug deductible of $590. After you meet your deductible, you will pay the costs for drugs in each tier until your total drug costs reach $2000. If you qualify for the low-income subsidy, you will pay $56.90 for Part D. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs, though you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The Longevity Health Plan (PPO I-SNP) offers a range of benefits with varying cost-sharing structures. Inpatient hospital stays have a $1300 copay, while outpatient services, including mental health and substance abuse, typically have a 20% coinsurance. Emergency services require a $110 copay, and ambulance services require a 20% coinsurance. Preventive services, primary care, and home health services have no copay or coinsurance. This plan also covers hearing and vision services, offering hearing aids and eyewear with set maximum benefits. Dental services have a 20% coinsurance, and medical equipment and dialysis services are covered with coinsurance.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered and require prior authorization. Both services have a copay of $1300 for a Medicare-covered stay, while additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services include coverage for Outpatient Hospital Services and Observation Services with a 20% coinsurance, along with Ambulatory Surgical Center (ASC) Services, Individual Sessions for Outpatient Substance Abuse, and Group Sessions for Outpatient Substance Abuse, each with a coinsurance of 20%. Outpatient Blood Services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered with prior authorization, and requires a 20% coinsurance.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a 20% coinsurance for both ground and air ambulance services; there is no copay. Transportation Services to a plan-approved health-related location are covered for 28 one-way trips per year via rideshare services, van, medical transport, or other means, but any health-related location is not covered.
Emergency Services See details
Emergency Services with the Longevity Health Plan (PPO I-SNP) has a $110 copay, while Urgently Needed Services has a 20% coinsurance. Worldwide Emergency Services, including coverage, urgent care, and transportation, are not covered.
Primary Care See details
The Longevity Health Plan (PPO I-SNP) covers primary care physician services, occupational therapy services, and physical therapy and speech-language pathology services with no coinsurance or copay. Chiropractic services and additional telehealth benefits are covered with a 20% coinsurance, while the coinsurance for physician specialist services can range from 0% to 20%.
Preventive Services See details
The Longevity Health Plan (PPO I-SNP) offers preventive services including glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a welcome visit; however, annual physical exams, health education, and other services are not covered. There is no copay or coinsurance for these services.
Hearing Services See details
The Longevity Health Plan (PPO I-SNP) covers hearing exams with a coinsurance of at most 20%, and fitting/evaluation for hearing aids. This plan also covers prescription hearing aids and OTC hearing aids, both with a maximum benefit of $2000 every two years.
Vision Services See details
Vision Services include coverage for eye exams with a 20% coinsurance. Eyewear is covered with a combined maximum benefit of $300 every two years for both in-network and out-of-network services. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
Dental Services are covered, with a 20% coinsurance for Medicare Dental Services. Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable), Maxillofacial Prosthetics, Implant Services, Prosthodontics (fixed), Oral and Maxillofacial Surgery, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Longevity Health Plan (PPO I-SNP). Medicare Part B Insulin Drugs have a $35 copay, with a coinsurance between 0% and 20%, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the Longevity Health Plan (PPO I-SNP) with a coinsurance between 20% and 20%.
Medical Equipment See details
The Longevity Health Plan (PPO I-SNP) covers Durable Medical Equipment (DME) with 20% coinsurance, and also covers Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts with 20% coinsurance. Durable Medical Equipment for use outside the home is not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered under the Longevity Health Plan (PPO I-SNP). Diagnostic Procedures/Tests, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services have a coinsurance of at most 20%, while Lab Services are not covered.
Home Health Services See details
Home Health Services are covered by the Longevity Health Plan (PPO I-SNP) with no copay or coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Longevity Health Plan (PPO I-SNP). Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered. Prior authorization is required for SNF services.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) items with a maximum benefit of $290.00 every three months, but does not cover Acupuncture, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services.
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