Your Network Health Anywhere PPO Comparison
Customer Service: 800-378-5234
EyeMed link: EyeDocLocator.com
EyeMed Phone: 833-279-4359
Dental Network link: SayCheese
Dental Network Phone: 888-454-4127
TruHearing: 877-759-8131
Find A Doc: NetworkHealth.com
New Gym Membership Link: YourOnePass.com
Mail Order with Express Scripts: 800-316-3107
For a full listing of the Network Health Anywhere PPO, please click here.
2024
2025
Anywhere
Anywhere
H5215-010
H5215-010
Southeastern
Southeastern
Premium
$0
$0
Part B Giveback
$25
$26
Primary Doctor
$0
$0
Specialist
$35
$35
Physical Therapy
$35
$35
Urgent Care
$45
$35
Hospital
$275 days 1-6
$275 days 1-6
MOOP Cap
$3,800
$3,800
Outpatient Surg
$260 / $185 ASC
$260 / $185 ASC
Ambulance
$250
$250
Emergency
$110
$125
Lab Services
$0 – $40
$0 – $40
X-Rays
$90
$90
Complex Diag
$260
$310
DME
20%
20%
Chemo/Part B
20%
20%
Part D
$2 / $8 / $42 / $95
$2 /$8 / 23% / 37%
90 Day- Mailorder
$0 / $0 / $105 / $237
$0 / $0 / 23%/ 37%
Part D Ded
$250
$300
(applies to tiers 4,5)
(applies to tiers 2,3,4,5)
Skilled Nursing
$0 days 1-20
$203 days 21-45
$0 days 1-20
$214 days 21-45
Hearing Aid
$495 – $1,695
$495 – $1,695
OTC
$75/Qtr
N/A
Gym Membership
SilverSneakers
One Pass
Dental
$3,000 (80% co-ins OON)
$2,000 (80% co-ins OON)
Dental Network
ANY/Delta Dental MA
Say Cheese
Vision
$350 (Eye Med)
$350 (Eye Med)
Your Network Health Anywhere PPO Comparison
2024
2025
Anywhere
Anywhere
H5215-010
H5215-010
Southeastern
Southeastern
Premium
$0
$0
Part B Giveback
$25
$26
Primary Doctor
$0
$0
Specialist
$35
$35
Physical Therapy
$35
$35
Urgent Care
$45
$45
Hospital
$275
days 1-6
$275
days 1-6
OON
N/A
N/A
MOOP Cap
$3,800
$3,800
Outpatient Surg
$260 / $185 ASC
$260 / $185 ASC
Ambulance
$250
$250
Emergency
$110
$125
Lab Services
$0-$40
$0-$40
X-Rays
$90
$90
Complex Diag
$260
$310
DME
20%
20%
Chemo/Part B
20%
20%
Part D
$2 / $8 / $42 / $95
$2 / $8 / 23% / 37%
90 Day- Mailorder
$0 / $0 / $105 / $237
$0 / $0 / $105 / $237
Part D Ded
$250
$300
(applies to tiers 4,5)
| (applies to tiers 2,3,4,5) |
Skilled Nursing
$0 days 1-20
$203 days 21-45
$0 days 1-20
$214 days 21-45
Hearing Aid
$495-$1,695
$495-$1,695
OTC
$75/Qtr
N/A
Gym Membership
SilverSneakers
One Pass
Dental
$3,000 (80% co-ins OON)
$2,000 (80% co-ins OON)
Dental Rider
N/A
N/A
Dental Network
ANY/Delta Dental MA
ANY/Delta Dental MA
Vision
$350
(Eye Med)
$350
(Eye Med)
Customer Service: 800-378-5234
EyeMed link: EyeDocLocator.com
EyeMed Phone: 833-279-4359
Dental Network link: SayCheese
Dental Network Phone: 888-454-4127
TruHearing: 877-759-8131
Find A Doc: NetworkHealth.com
New Gym Membership Link: YourOnePass.com
Mail Order with Express Scripts: 800-316-3107
For a full listing of the Network Health Anywhere PPO, please click here.