H4141 003

Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) Location: Fulton, Georgia Click to see other locations. Plan ID: H4141 - 021 - 0 Click to see other plans. Member Services: 1-800-457-4708 TTY users 711. Medicare Contact Information: Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options.

Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) Annual Notice of Changes for 2024 6 For PageNumber2 Summary of Important Costs for 2024 The table below compares the 2023 costs and 2024 costs for Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) in several important areas. Please note this is only a summary of costs. Cost 2023 (this year) 2024 (next year)Learn More about Humana Inc. Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. Speak with a licensed insurance agent 1-855-298-6309 TTY 711, 24/7. 1-855-298-6309.2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) in GA Plan Benefits ExplainedH4141-021 (HMO D-SNP) Find out more about the Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) plan -including the health and drug services it covers -in this easy-to-use guide. Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) is aCoordinated Care plan HMO with a Medicare contract and acontract with the Georgia Department of …Oct 26, 2023 · TTY 711, Mon-Sun 8 am - 11 pm EST. Established in 1961, Humana Inc. is a health insurance company based in Louisville, Kentucky. It’s currently the fifth largest provider of health insurance in ... Humana Gold Plus H4141-017 (HMO) Georgia Important Message About What You Pay for Vaccines Our plan covers most Part D vaccines at no cost to you, no matter what cost-sharing tier it's on. Important Message About What You Pay for Insulin You won't pay more than $35 for a one-month (up to 30-day) supply of each Part D insulin product covered bySunFireMatrixHumana Gold Plus H4141-015 (HMO) Annual Notice of Changes for 2024 6 For PageNumber2 Summary of Important Costs for 2024 The table below compares the 2023 costs and 2024 costs for Humana Gold Plus H4141-015 (HMO) in several important areas. Please note this is only a summary of costs. Cost 2023 (this year) 2024 (next year) In …

Browse the Humana Gold Plus H4141-017 (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase: $4.00: $12.00: $47.00 ...This plan, Humana Gold Plus H4141-015 (HMO), is offered by Humana Employers Health Plan of Georgia, Inc. (When this Evidence of Coverage says "we," "us," or "our," it means Humana Employers Health Plan of Georgia, Inc. When it says "plan" or "our plan," it means Humana Gold Plus H4141-015 (HMO).) This document is available for free in Spanish. Mental health services. Inpatient hospital - psychiatric. $587 per day for days 1 through 3 / $0 per day for days 4 through 90. Outpatient group therapy visit with a psychiatrist. $45 copay ... H4141-003 (HMO D-SNP) Find out more about the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan -including the health and drug services it covers -in this easy-to-use guide. Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is aCoordinated Care plan HMO with a Medicare contract and acontract with the Georgia Department of … Browse the Humana Gold Plus H4141-017 (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase: $4.00: $12.00: $47.00 ...

Learn More about Humana Inc. Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) Plan Details, including how much you can expect to pay for coinsurance, deductibles, premiums and copays for various services covered by the plan. Speak with a licensed insurance agent 1-855-298-6309 TTY 711, 24/7. 1-855-298-6309.Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2026 based on a review of Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)'s Model of Care. This document is available for free in Spanish.Humana Gold Plus H4141-015 (HMO) Annual Notice of Changes for 2024 6 For PageNumber2 Summary of Important Costs for 2024 The table below compares the 2023 costs and 2024 costs for Humana Gold Plus H4141-015 (HMO) in several important areas. Please note this is only a summary of costs. Cost 2023 (this year) 2024 (next year) In-Network In-NetworkHumana Gold Plus SNP-DE H4141-021 (HMO D-SNP) is a Coordinated Care plan HMO with a Medicare contract and a contract with the Georgia Department of Community Health (DCH) (Medicaid) program . Enrollment in this Humana plan depends on contract renewal. The benefit information provided is a summary of what we cover and what you pay.

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4 out of 5 stars* for plan year 2024. Humana Gold Plus H4141-017 (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-017-003. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Gold Plus SNP-DE H4141-003 (HMO D-SNP) providers aren't allowed to collect or bill you for services and items covered under Medicare Part A and Part B, including deductibles, coinsurance, and copayments – even when Medicaid payment is zero or a provider chooses to not submit to Medicaid. If a provider asks you to pay, that's against the law. Copayment for Medicare Covered Lab Services $0.00 to $40.00. Copayment for Medicare Covered Diagnostic Radiological Services $0.00 to $300.00. Copayment for Medicare Covered Therapeutic Radiological Services $35.00 to $60.00. Copayment for Medicare Covered Outpatient X-Ray Services $5.00 to $125.00. Home Health Care.According to a study conducted by computer security company Sophos, anywhere from 41 to 49 percent of users (by age group) they test-requested friendship with on Facebook accepted ... Gold Plus SNP-DE H4141-021 (HMO D-SNP) providers aren't allowed to collect or bill you for services and items covered under Medicare Part A and Part B, including deductibles, coinsurance, and copayments – even when Medicaid payment is zero or a provider chooses to not submit to Medicaid. If a provider asks you to pay, that's against the law. How a D-SNP works. Medicare Advantage D-SNPs offer special benefits, including prescription drug coverage, with every plan. All of our D-SNPs include a Healthy Options Allowance to help pay for things like food, pet supplies, utility bills or rent. And starting in 2024, all Humana Special Needs Plans will include dental, vision and hearing ...

Browse the Humana Gold Plus H4141-017 (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase ...Humana Gold Plus H4141-017 (HMO) Georgia Important Message About What You Pay for Vaccines Our plan covers most Part D vaccines at no cost to you, no matter what cost-sharing tier it's on. Important Message About What You Pay for Insulin You won't pay more than $35 for a one-month (up to 30-day) supply of each Part D insulin product covered by2024 Evidence of Coverage for Humana Gold Plus H4141-017 (HMO) 10 Chapter 1 Getting started as a member SECTION 1 Introduction Section 1.1 You are enrolled in Humana Gold Plus H4141-017 (HMO), which is a Medicare HMO You are covered by Medicare, and you have chosen to get your Medicare health care and your …2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 in GA Plan Benefits ExplainedPlus, HMO plans usually have lower monthly premiums and copays than other plan types. Like all Medicare Advantage plans, HMO plans include all the benefits of Medicare Parts A and B—and most include coverage for prescription drugs. They also offer the added security of an annual maximum out-of-pocket cost limit. Once you’ve reached that ...By taking the time to research and compare Medicare Advantage plans, you can find the one that benefits you the most. * SNPs can be any type of MA plan such as an HMO or PPO. Licensed Humana sales agents are available Monday – Friday, 8 a.m. – 8 p.m. 1-888-204-4062 (TTY: 711)A Medicare Advantage Special Needs Plan for dual-eligible beneficiaries in Georgia. No premium, no deductible, low drug costs, and extra benefits for in-network services. 3.5 out of 5 stars* for plan year 2024. HumanaChoice R4182-003 (Regional PPO) is a Regional PPO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: R4182-003-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $72.00 Monthly Premium.

Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) Annual Notice of Changes for 2024 6 For PageNumber2 Summary of Important Costs for 2024 The table below compares the 2023 costs and 2024 costs for Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) in several important areas. Please note this is only a summary of costs. Cost 2023 (this year) 2024 (next year)

Humana Gold Plus H4141-017 (HMO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage. Cost. Chiropractic Services. In-Network: Copayment for Medicare-covered Chiropractic Services $15.00.The Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) has a monthly premium of $29.70. That is $356.40 for 12 months. There are a few factors that can increase or decrease this premium. If you qualify for full or partial extra help, your premium will be lower. If you have a premium penalty, your premium will be higher.In exchange for the added flexibility, PPOs tend to have higher monthly premiums. Like all Medicare Advantage plans, PPO plans include all the benefits of Medicare Parts A and B—and many include coverage for prescription drugs. They also offer the added security of an annual maximum out-of-pocket cost limit. Once you’ve reached that limit ...If you don't join another plan by December 7, 2023, you will stay in Humana Gold Plus H4141-017 (HMO). To change to a different plan, you can switch plans between October 15 and December 7. Your new coverage will start on January 1, 2024. This will end your enrollment with Humana Gold Plus H4141-017 (HMO).A Medicare Advantage Special Needs Plan for dual-eligible beneficiaries in Georgia. No premium, no deductible, low drug costs, and extra benefits for in-network services.Vision benefits include: Annual eye exams. Annual allowance for eyeglasses or contact lenses. Glaucoma screenings. Diabetic eye exams. For even greater benefits, a dental or vision Optional Supplemental Benefit plan may be a great option. These Medicare dental and vision plans are paired with specific Medicare Advantage plans.2020 Medicare Advantage Plan Benefit Details for the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0. This is archive material for research purposes. …

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Mental health services. Inpatient hospital - psychiatric. $587 per day for days 1 through 3 / $0 per day for days 4 through 90. Outpatient group therapy visit with a psychiatrist. $45 copay ... 703 Medicare Advantage Plans from Humana. Coverage varies by plan. Select a Medicare Advantage Plan below to view details about the coverage it provides: Plan CodePlan Name. H0028:007-0 Humana Gold Plus SNP-DE H0028-007 (HMO D-SNP) H0028:014-0 Humana Gold Plus H0028-014 (HMO) H0028:015-0 Humana Gold Plus SNP-DE H0028-015 …Browse the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial ...The maximum deductible for 2022 is $480. This plan (Humana Gold Plus H4141-017 (HMO)) has no deductible. The following information is about the Humana Gold Plus H4141-017 (HMO) formulary (or drug list). There are 3408 drugs on the Humana Gold Plus H4141-017 (HMO) formulary.2017 Humana Gold Plus SNP-DE H4141-003 (HMO SNP) in GA Plan Benefits ExplainedFeb 20, 2013 ... 3 stc 2240806 2240808 + ID1_N003 ID2_N003T0 SP12. ... 3 XE 2240077 2241254 + ID1_N003 ... Tagged ... A , B ,C ,D ,E ,F,G ,H 4141,127337,24,15,20 ...2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 in GA Plan Benefits ExplainedIn exchange for the added flexibility, PPOs tend to have higher monthly premiums. Like all Medicare Advantage plans, PPO plans include all the benefits of Medicare Parts A and B—and many include coverage for prescription drugs. They also offer the added security of an annual maximum out-of-pocket cost limit. Once you’ve reached that limit ...H4141-017 (HMO) Find out more about the Humana Gold Plus H4141-017 (HMO) plan -including the health and drug services it covers -in this easy-to-use guide. Humana Gold … ….

94% of our Medicare Advantage members are in plans rated 4 out of 5 stars or higher for 2024 by the Centers for Medicare and Medicaid.*. And for the third year in a row, Humana overall received the highest Customer Experience Index™ score among health insurers in Forrester’s proprietary 2023 CX Index™ survey.†.Plastic wrap can be a pain in the butt. It often sticks to itself and comes off the roll poorly. Fortunately, you can make your life easier with two little tips to help you use i...2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) in GA Plan Benefits ExplainedOver 300,000 users have signed up for the MySpace clone "SpaceHey." What's their deal? It’s finally your turn on the family’s desktop computer. It takes forever to boot up. (You ki...The maximum deductible for 2022 is $480. This plan (Humana Gold Plus H4141-017 (HMO)) has no deductible. The following information is about the Humana Gold Plus H4141-017 (HMO) formulary (or drug list). There are 3408 drugs on the Humana Gold Plus H4141-017 (HMO) formulary. The Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan offers the following prescription drug coverage, with an annual drug deductible of $0 per year. Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-021-000. * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. $0.00 Monthly Premium. Georgia Medicare beneficiaries may want to consider ...Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2026 based on a review of Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)'s Model of Care. This document is available for free in Spanish.Humana Gold Plus H4141-015 (HMO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B). Coverage Cost; Chiropractic Services: In-Network: Copayment for Medicare-covered Chiropractic Services $20.00 Prior Authorization Required for Chiropractic Services2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) in GA Plan Benefits Explained H4141 003, Humana Gold Plus H4141-017 (HMO) is a HMO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-017-003 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system. , We would like to show you a description here but the site won’t allow us., Copayment for Medicare Covered Lab Services $0.00 to $40.00. Copayment for Medicare Covered Diagnostic Radiological Services $0.00 to $300.00. Copayment for Medicare Covered Therapeutic Radiological Services $35.00 to $60.00. Copayment for Medicare Covered Outpatient X-Ray Services $5.00 to $125.00. Home Health Care., Plus, HMO plans usually have lower monthly premiums and copays than other plan types. Like all Medicare Advantage plans, HMO plans include all the benefits of Medicare Parts …, Apr 6, 2021 ... 4062 (Word version) (COUNCIL\PH\4062C003. ... 3560 (Word version) (COUNCIL\PH\3560C003.JN.PH21), which was adopted: ... H. 4141 (Word version) -- ..., Browse the Humana Gold Plus H4141-017 (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase: $4.00: $12.00: $47.00 ..., H4141-003 (HMO D-SNP) Find out more about the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan - including the health and drug services it covers - in this easy-to-use guide. , Humana Gold Plus H4141-017 (HMO) is a Medicare Advantage (Part C) Plan by Humana. Premium: $6. Enroll Now. This page features plan details for 2022 Humana Gold Plus H4141-017 (HMO) H4141 – 017 – 4 available in Select counties in Georgia. IMPORTANT: This page features the 2022 version of this plan. See the 2024 version using the link below:, 2017 Humana Gold Plus SNP-DE H4141-003 (HMO SNP) in GA Plan Benefits Explained, 2024 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 in GA Plan Benefits Details. Medicare Advantage Plans. 2024 Medicare Advantage Plan Benefit …, Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is a HMO D-SNP Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-003-000 * Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system., Indices Commodities Currencies Stocks, Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $300.00. Copayment for Medicare-covered Therapeutic Radiological Services $5.00. Coinsurance for Medicare-covered Therapeutic Radiological Services 20%. Copayment for Medicare-covered X-Ray Services $0.00 to $125.00., Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) 4 out of 5 stars. Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-003., Browse the Humana Gold Plus H4141-015 (HMO) Formulary: This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. This plan offers select insulin at a $35 copay. Learn more. Formulary Drug Details: Tier 1: Tier 2: Tier 3: Tier 4: Tier 5 • Preferred Pharmacy Cost-Sharing during initial coverage phase: $0.00: $12.00: $47.00 ..., H4141:003-0 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) H4141:015-0 Humana Gold Plus H4141-015 (HMO) H4141:017-3 Humana Gold Plus H4141-017 (HMO) H4141:017-5 Humana Gold Plus H4141-017 (HMO) H4141:021-0 Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) H5216:073-0 HumanaChoice H5216-073 (PPO) …, EATON VANCE GEORGIA MUNICIPAL INCOME FUND CLASS A- Performance charts including intraday, historical charts and prices and keydata. Indices Commodities Currencies Stocks, Jul 6, 2022 ... ),,, Sn,• 'h. .4141, .,,,,,I....;,,, : 4 ... 10/01413dOISC00190A003. 40100130000009930113 ... CAMA960403mOCRR003. I8. 13,500.00., H4141-017 (HMO) Find out more about the Humana Gold Plus H4141-017 (HMO) plan -including the health and drug services it covers -in this easy-to-use guide. Humana Gold Plus H4141-017 (HMO) is aMedicare Advantage HMO plan with a Medicare contract. Enrollment in this Humana plan depends on contract renewal., Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) 4 out of 5 stars. Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is a HMO Medicare Advantage (Medicare Part C) plan offered by Humana Inc. Plan ID: H4141-003., In exchange for the added flexibility, PPOs tend to have higher monthly premiums. Like all Medicare Advantage plans, PPO plans include all the benefits of Medicare Parts A and B—and many include coverage for prescription drugs. They also offer the added security of an annual maximum out-of-pocket cost limit. Once you’ve reached that limit ..., Plastic wrap can be a pain in the butt. It often sticks to itself and comes off the roll poorly. Fortunately, you can make your life easier with two little tips to help you use i..., 2017 Humana Gold Plus SNP-DE H4141-003 (HMO SNP) - H4141-003-0 in GA Plan Benefits Explained, The third annual MetLife Triangle Tech X Conference is going by the theme Women and STEM: Harnessing the Great Reevaluation this year. The third annual MetLife Triangle Tech X Conf..., Humana - H4141 For 2022, Humana - H4141 received the following Star Ratings from Medicare: Overall Star Rating: Health Services Rating: Drug Services Rating: Every year, Medicare evaluates plans based on a 5-star rating system. The number of stars show how well a plan performs. EXCELLENT ABOVE AVERAGE AVERAGE BELOW AVERAGE …, Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2023 based on a review of Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)'s Model of Care. This document is available for free in Spanish., Humana Gold Plus H4141-015 (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,350 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. , This plan is a dual eligible special needs plan (D-SNP). 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. This plan may enroll FBDE, QMB, QMB+, SLMB+. 2023. Summary of Benefits. Humana Gold Plus SNP-DE H5619-054 (HMO D-SNP) Indiana Select ..., H4141-003 (HMO D-SNP) Find out more about the Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) plan -including the health and drug services it covers -in this easy-to-use guide. Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) is aCoordinated Care plan HMO with a Medicare contract and acontract with the Georgia Department of …, Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) has been approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until December 31, 2023 based on a review of Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP)'s Model of Care. This document is available for free in Spanish., Call us. Licensed Humana sales agents can help. Call 1-888-204-4062 (TTY: 711) Monday – Friday, 8 a.m. – 8 p.m. Call 1-888-204-4062 (TTY: 711) Monday – Friday, 8 a.m. – 8 p.m. 2024 Medicare Advantage (Part C) plans include all the coverage of Medicare Parts A and B, plus extra benefits, like dental, vision and hearing care. See …, The digestive system breaks down food into vital energy as well as expelling waste from the body. The digestive system breaks down food into vital energy as well as expelling waste..., Outpatient Diag/Therapeutic Rad Services: Copayment for Medicare-covered Diagnostic Radiological Services $0.00 to $300.00. Copayment for Medicare-covered Therapeutic Radiological Services $5.00. Coinsurance for Medicare-covered Therapeutic Radiological Services 20%. Copayment for Medicare-covered X-Ray Services $0.00 to $125.00.