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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 2026, 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 out of 5 stars in 2026.
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 $172.00. 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 $615.00 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 $10100.00 (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 $10100.00 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) includes an annual prescription drug deductible of $615. This means you will pay the full cost of your medications up to this amount before your plan coverage begins to pay. Detailed information regarding specific drug tiers, copays, and coinsurance is not currently available for this plan. To determine your exact out-of-pocket costs for your specific prescriptions, we recommend checking the plan's formulary or contacting the plan provider directly.
Additional Benefits
The Longevity Health Plan (PPO I-SNP) offers robust coverage with no copay and no coinsurance for a wide range of essential services, including primary care, specialist visits, outpatient hospital services, emergency care, and home health services. For inpatient hospital stays, members are responsible for a $1,300 copay per stay with no coinsurance. Skilled nursing facility care, diagnostic services, and partial hospitalization are also covered with no copay or coinsurance. This plan also features valuable supplemental benefits, including routine hearing exams and hearing aids up to $2,000 every two years, and routine vision exams with a $300 eyewear allowance, all with no copay or coinsurance. While medical equipment, dialysis, and Medicare Part B drugs carry up to a 20% coinsurance and no copay, members also receive limited dental coverage and a $135 quarterly over-the-counter allowance. Additionally, the plan covers up to 28 one-way routine transportation trips per year with no copay and no coinsurance.
Inpatient Hospital See details
Longevity Health Plan (PPO I-SNP) covers inpatient acute and psychiatric hospital stays with a $1,300 copayment per Medicare-covered stay and no coinsurance, subject to prior authorization. This benefit is partially covered, as additional days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance for outpatient hospital, ambulatory surgical center, and blood services. Outpatient substance abuse services are partially covered, with individual and group sessions not covered.
Partial Hospitalization See details
Partial hospitalization services are covered by Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance. Prior authorization is required to access this benefit.
Ambulance and Transportation Services See details
Ambulance and transportation services are partially covered by Longevity Health Plan (PPO I-SNP), which offers transportation with no copay and no coinsurance for up to 28 one-way trips per year to plan-approved locations. However, transportation to any health-related location is not covered, and ground and air ambulance services are also not covered.
Emergency Services See details
Longevity Health Plan (PPO I-SNP) covers emergency and urgently needed services with no copay and no coinsurance. For worldwide emergency services, some services are covered, but worldwide emergency coverage, worldwide urgent coverage, and worldwide emergency transportation are not covered.
Primary Care See details
Longevity Health Plan (PPO I-SNP) covers primary care, specialist visits, physical, occupational, and speech therapies, podiatry, telehealth, and opioid treatment with no copay and no coinsurance. Chiropractic, mental health specialty, and psychiatric services are not covered under this plan.
Preventive Services See details
Longevity Health Plan (PPO I-SNP) partially covers preventive services, offering Medicare-covered zero-dollar services, kidney disease education, glaucoma screenings, and diabetes self-management training with no copay and no coinsurance. However, annual physical exams and additional preventive services, such as fitness benefits, health education, and in-home safety assessments, are not covered.
Hearing Services See details
Hearing services are covered under the Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance for routine annual exams, fittings, and hearing aids. While prescription and OTC hearing aids are covered up to a $2,000 maximum every two years, prescription hearing aids are only partially covered, excluding inner ear, outer ear, and over the ear models.
Vision Services See details
Vision services are partially covered by Longevity Health Plan (PPO I-SNP) with no copay, no coinsurance, and no deductible, though other eye exam services are not covered. Covered benefits include one routine eye exam per year and up to $300 every two years for eyewear, including contact lenses, eyeglasses, and upgrades.
Dental Services See details
Dental services are partially covered by Longevity Health Plan (PPO I-SNP), which offers Medicare-covered dental services with no copay and no coinsurance, subject to prior authorization. However, other dental and orthodontic services—including oral exams, cleanings, x-rays, fluoride, restorative services, and orthodontics—are not covered.
Home Infusion bundled Services See details
Longevity Health Plan (PPO I-SNP) covers home infusion bundled services with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs have no copay and range from no coinsurance to 20% coinsurance, while Part B insulin has a $35 copay and no coinsurance to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by Longevity Health Plan (PPO I-SNP) with no copay and a 20% coinsurance.
Medical Equipment See details
Longevity Health Plan (PPO I-SNP) covers durable medical equipment, prosthetics, medical supplies, and diabetic equipment with no copay and a 20% coinsurance. Prior authorization is required for these covered services, and there are no manufacturer or vendor restrictions.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance, though prior authorization is required. While some services are covered, diagnostic procedures, lab services, radiological services, and outpatient X-rays are not covered.
Home Health Services See details
Home Health Services are covered under the Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Longevity Health Plan (PPO I-SNP) covers some Cardiac Rehabilitation Services with no copay and no coinsurance, subject to prior authorization, but standard cardiac, intensive cardiac, pulmonary, and SET for PAD services are not covered.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance, though prior authorization and a prior three-day inpatient hospital stay are required. Additional days beyond the standard Medicare-covered limit are not covered, and no cost-sharing is charged on the day of discharge.
Other Services See details
Longevity Health Plan (PPO I-SNP) provides partial coverage for other services, featuring an over-the-counter (OTC) benefit of $135 every three months with no copay and no coinsurance. Acupuncture, meal benefits, nicotine replacement therapy, and naloxone are not covered.
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* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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