Medicare Flex

Benefit & Cost-Share



Monthly Premium* With Part D: $42
Without Part D: $0
Medical Deductible $0
Primary Care Physician Office Visit Copayment $0 $40
Doctor On Demand $0 N/A
Special Office Visit Copayment $40 30%
Routine Annual Physical Exam Copayment $0 30%
Over-the-counter Items  $25 / quarter Not available 
Help at Home and Companionship
Up to 30 hours of companionship, transportation, help around the house, and technology assistance
Not available
Urgent Care Copayment $60 $60
Emergency Room Copayment $90 $90
Ambulance $255 $255
Ambulatory Surgery Center $250 30%
Outpatient Hospital Services $325 30%
Inpatient Hospitalization Days 1-6; $310
No copayment after day 6
Skilled Nursing Facility Care $0 days 1-20
$145 days 21-100
Delta Dental Provider:
Routine Cleanings/Restorative (per year)
2 cleanings; $20 copay per exam
Restorative $60-$595
- Delta Dental Medicare Advantage Network for CDPHP®
Not available
Non Delta Dental Provider:
Routine Cleaning/Restorative/Dentures
$250 allowance
- Annual Routine Eye Exam


 - Frames/Lenses(per year)
(20% coinsurance for one pair after cataract surgery)
$125 allowance
Hearing Care Solutions Hearing Aid Benefit $599 or $899 N/A
Meal Delivery Following Inpatient Stay 14 meals provided Not Covered
Diagnostic Tests and Lab Services $0 or $40 30%
X-rays $40 $40
Advanced Imaging Studies (CT, MRI, etc.) $135 30%
Part B Drugs and Radiation Therapy 20% 30%
CaféWell and Incentives $125
OOP Max $5,500 $10,000

*You must continue to pay your Medicare Part B premium.


View the Flex and Flex Rx plan Evidence of Coverage (EOC) and Summary of Benefits (SOB) for all covered services.


Review your estimated prescription costs with this plan



  1. Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.

  2. Copayment waived if services received at a preferred laboratory.

  3. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change on January 1, 2023. Limitations, copayments, and restrictions may apply.

  4. Out-of-network/non-contracted providers are under no obligation to treat Medicare Flex/ Flex Rx members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

CDPHP Medicare Advantage is an HMO and PPO plan with a Medicare contract. Enrollment in CDPHP Medicare Advantage depends on contract renewal.

Y_0019_22_16818 – last updated 11/04/2021

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Our hours are 8 a.m. – 8 p.m. seven days a week, October 1 – March 31. From April 1 to September 30, Monday – Friday, our hours are 8 a.m. to 8 p.m. A voice messaging service is used weekends, after-hours, and federal holidays. Calls will be returned within one business day.

Medicare Hearing Care

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CDPHP best Medicare by US News - 2022

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