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 Zing Dual Platinum Plus (DSNP-POS) |
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Zing Dual Platinum Plus Dual Special Needs Plan is a select care plan offering high-touch specialized primary care from Oak Street Health (OSH) to residents of Marion County, Indiana. Eligible members must select an OSH PCP and have Medicare and full Medicaid benefits. Generally, members may see out-of-network providers for Medicare-covered services. Additionally, this plan helps members overcome barriers to care by offering services like care coordination, unlimited routine transportation, behavioral health services, in-home support services, monthly grocery allowance, and enhanced supplemental benefits. |
Premium: Often $0(Determined by Medicaid.) |
Service Areas |
Indiana
Marion |
Low out-of-pocket maximum: |
View Benefit Highlights
Medical Benefit Highlights
- $0 copay Telehealth visits
- $0 copay for lab work and X-rays
- Worldwide emergency care coverage
- Oak Street Health providers
Pharmacy Benefit Highlights
- $0 copay tier 1 generic drugs
- $480 pharmacy deductible
- Sildenafil (generic Viagra) now covered
- Insulin Savings Program
Extra Benefit Highlights
- Over-the-counter debit card
- Transportation to medical appointments and pharmacies
- Personal emergency response system
- In-home support services through Papa
- Flex card to help cover out-of-pocket expenses
- Preventive and comprehensive dental benefit
- Annual eye exam plus eyewear allowance
- Hearing aid allowance every three years, plus hearing exam and fittings
- Food card for members with qualifying conditions
- Silver&Fit health club membership and home workout kit
- WW (formerly Weight Watchers) membership
Download Summary of BenefitsFrequently Asked Questions
To join a Zing Health Medicare Advantage plan, you must be entitled to Medicare Part A, be enrolled in Part B, and live in the plan’s service area.
For our chronic condition special needs plans (CSNP) plans only, your ability to enroll will be based on verification that you have a qualifying specific severe or disabling chronic condition. Zing Health’s CSNP plans currently cover members with diabetes, cardiovascular disease, and/or chronic heart failure.
For our dual eligible special needs plans (DSNP) only, your ability to enroll will be based on verification that you are entitled to both Medicare and medical assistance from a state plan under Medicaid. Zing Health’s DSNP plans are currently available to residents of the Michigan and Indiana counties in our service area.
For our chronic condition special needs plans (CSNP) plans only, your ability to enroll will be based on verification that you have a qualifying specific severe or disabling chronic condition. Zing Health’s CSNP plans currently cover members with diabetes, cardiovascular disease, and/or chronic heart failure.
For our dual eligible special needs plans (DSNP) only, your ability to enroll will be based on verification that you are entitled to both Medicare and medical assistance from a state plan under Medicaid. Zing Health’s DSNP plans are currently available to residents of the Michigan and Indiana counties in our service area.
Members with a qualifying chronic condition can purchase plan-approved food products through a mail order solution or at participating retail locations using their physical card.
Members receive a monthly allowance to buy healthy foods and produce.
Qualifying chronic conditions are:
- Chronic alcohol and other drug dependence
- Autoimmune disorders
- Cancer, excluding pre-cancer conditions or in-situ status
- Cardiovascular disorders
- Chronic heart failure
- Dementia
- Diabetes mellitus
- End-stage liver disease
- End-stage renal disease (ESRD) requiring dialysis
- Severe hematologic disorders
- HIV/AIDS
- Chronic lung disorders
- Chronic and disabling mental health conditions
- Neurologic disorders
- Stroke
Members, under the guidance of their primary care providers, are encouraged to be engaged and actively participate in the decision-making process, as it pertains to their individual care plan. By taking a collaborative approach to treating the “whole” person, members will be linked to community-based resources, as needed, based on the outcomes derived from Social Determinants of Health (SDOH). Zing has been deliberate in the steps taken to remove access related barriers for both the member and providers to promote a seamless care experience.
Zing Health plans have monthly premiums ranging from $0 to $25, depending on the plan. In addition, you must keep paying your Medicare Part B premium, which for most people, comes out of your Social Security check. Zing Health plans protect you by having yearly limits on your out-of-pocket costs for medical and hospital care. (This does not include prescription drug out-of-pocket costs.) If you reach the limit on out-of-pocket costs, we will pay the full cost for the rest of the year for Medicare-covered medical and hospital services. See your Summary of Benefits for each plan’s premium and out-of-pocket maximum.
You are encouraged to only use a hospital emergency room only in the event of a true emergency, such as (but not limited to) symptoms of a heart attack or stroke, difficulty breathing, or severe injuries. Emergency room copays range from $90 to $120, depending on the plan you are enrolled in, but will be waived if you are admitted to the hospital within 24 hours. (Worldwide emergency care is covered at $0 copay.)
If you are not feeling well (such as a rash, symptoms of the flu, headache, or a stomach bug) or have a minor injury (such as a cut that needs stitches or a joint sprain) and you cannot get in to see your primary care provider fast enough, you may want to go to an in-network urgent care center, where your copay will be $10. Waiting times at urgent care centers are usually much shorter than at hospital emergency rooms, and many of them will allow you to “get in line” online at home.
If you are not feeling well (such as a rash, symptoms of the flu, headache, or a stomach bug) or have a minor injury (such as a cut that needs stitches or a joint sprain) and you cannot get in to see your primary care provider fast enough, you may want to go to an in-network urgent care center, where your copay will be $10. Waiting times at urgent care centers are usually much shorter than at hospital emergency rooms, and many of them will allow you to “get in line” online at home.