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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 $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 $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 $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) has a $590 deductible for prescription drugs. After you meet your deductible, you will pay the costs associated with your drugs based on the tier and pharmacy you use. Once your total drug costs reach $2,000, you enter the next coverage phase. If you qualify for the low-income subsidy, your Part D premium will be reduced from $172.00 to $115.10.
Additional Benefits
The Longevity Health Plan (PPO I-SNP) offers a range of benefits with varying costs. Inpatient hospital stays have a $1300 copay, and outpatient services, emergency services, primary care, preventive services, and home health services have no copay. Other services like hearing, vision, and dental have defined limits and cost-sharing, while some services such as ambulance, transportation, and medical equipment have coinsurance requirements. This plan also includes coverage for home infusion, dialysis, and diagnostic services with copays or coinsurance. Additionally, it offers benefits like over-the-counter items up to a certain amount. However, some services such as worldwide emergency coverage, annual physical exams, and certain dental and vision services may not be covered.
Inpatient Hospital See details
Inpatient Hospital coverage includes both Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, each with a $1300 copay for a Medicare-covered stay, but additional days, non-Medicare-covered stays, and upgrades are not covered. Prior authorization and a doctor referral are required.
Outpatient Services See details
Outpatient Services, including all outpatient hospital services, observation services, and ambulatory surgical center services, are covered by the Longevity Health Plan (PPO I-SNP). Outpatient substance abuse services are partially covered, but individual and group sessions are not covered, and outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the Longevity Health Plan (PPO I-SNP), but ground and air ambulance services are not covered. Transportation Services to a plan-approved health-related location are covered for up to 28 one-way trips per year, with no copay and no coinsurance.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Longevity Health Plan (PPO I-SNP) with no copay and no coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation are not covered.
Primary Care See details
Primary Care benefits include coverage for primary care physician services, occupational therapy services, physical therapy, and speech-language pathology services with no copay or coinsurance. Chiropractic services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, and opioid treatment program services are covered, but require prior authorization. Podiatry services are covered, with 2 visits per year. Additional Telehealth benefits are also covered, including services not usually covered by Medicare plans. However, routine chiropractic care, individual sessions for mental health specialty services, and group sessions for mental health specialty services, and individual and group sessions for psychiatric services are not covered.
Preventive Services See details
The Longevity Health Plan (PPO I-SNP) covers Medicare-covered preventive services with no copay. However, annual physical exams, health education, and other services are not covered.
Hearing Services See details
Hearing services include routine hearing exams, fitting/evaluation for hearing aids, prescription hearing aids, and OTC hearing aids. Routine hearing exams are covered for one visit every year, and fitting/evaluation for hearing aids are covered with no limit. Prescription hearing aids are covered up to $2000 every two years, and OTC hearing aids are covered up to $2000 every two years. Hearing aids for the inner ear, outer ear, and over the ear are not covered.
Vision Services See details
Vision services include routine eye exams, eyewear, contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades. There is coverage for one routine eye exam every year, and a combined maximum of $300 for eyewear every two years.
Dental Services See details
Dental Services are partially covered under the Longevity Health Plan (PPO I-SNP), with Medicare Dental Services covered, but Orthodontic Services, Restorative Services, Adjunctive General Services, Endodontics, Periodontics, Prosthodontics (removable and fixed), Maxillofacial Prosthetics, Implant Services, Oral and Maxillofacial Surgery, and Orthodontics not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay, and coinsurance between 0-20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is coinsurance between 0-20%.
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
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with a 20% coinsurance. Diabetic Equipment benefits include Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts, each with a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Longevity Health Plan (PPO I-SNP), but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for covered services.
Home Health Services See details
Home Health Services are covered by the Longevity Health Plan (PPO I-SNP) with no copay or coinsurance, but authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but this plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. Prior authorization is required for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but additional days beyond Medicare coverage and non-Medicare-covered stays are not covered. Prior authorization is required.
Other Services See details
Other Services includes coverage for over-the-counter items, with a maximum benefit of $205 every three months. Acupuncture, meal benefits, and several other services are not covered.
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