
We’ve got you covered from head to toe.
NO Deductibles
With Essence Advantage, there are no annoying deductibles to meet. Your coverage begins right away.
Complete Coverage With One Plan From One Company
Unlike Original Medicare plans, Essence bundles your medical, hospital and prescription drug coverage together in one comprehensive plan.
The plan comes with valuable extra benefits that save you even more.
Low Copays on Generic Prescriptions
Save even more money on your prescription drugs when you fill your prescription at preferred pharmacies. Essence members can get generic prescriptions for $5 copays and reduced copays on brand-name medications at any participating preferred pharmacy.
Important Financial Protection
Essence protects your savings and retirement by putting an annual limit on what you have to pay out of your own pocket for your covered medical expenses—important protection not offered by Original Medicare plans.
Important Travel Coverage
Whether you are making a trip out of the state or out of the country, we have you covered. If you ever get sick or injured when away from home, you can rest easy knowing you have emergency or urgent-care coverage.
Benefits at a Glance
Hospital and Medical Coverage
Part D Drug Coverage
Each Essence plan also includes generous prescription drug coverage. While we offer low copays
at all participating pharmacies, you also have the option of saving even more if you get your
prescriptions filled at a preferred pharmacy.
Essence Advantage Gold (HMO) – Alameda/San Mateo
*30-Day Supply
**Select Care drugs are generic drugs on Tier 6
Insulin Savings Program
As an Essence member, you’ll have low, predictable copays on Select Insulins through the Insulin Savings Program.† Costs for Select Insulins will remain the same during the Initial Coverage and Coverage Gap phases of your prescription drug benefit. The program doesn’t apply during the Catastrophic Coverage stage. Note that this program isn’t available if you receive Extra Help from the government.
Standard Retail Cost Sharing
Tier 2 Select Insulins†
30-Day Supply: $15 copay
60-Day Supply: $30 copay
90-Day Supply: $45 copay
Tier 3 Select Insulins†
30-Day Supply: $35 copay
60-Day Supply: $70 copay
90-Day Supply: $105 copay
Standard Mail-Order Cost Sharing
Tier 2 Select Insulins†
30-Day Supply: Not Offered
60-Day Supply: Not Offered
90-Day Supply: $30 copay
Tier 3 Select Insulins†
30-Day Supply: Not Offered
60-Day Supply: Not Offered
90-Day Supply: $94 copay
†Select Insulins are those that are part of the Insulin Savings Program and therefore will incur low, consistent copays through the coverage gap. For information regarding which insulins are Select Insulins under the plan’s benefit, refer to the plan’s Prescription Drug Formulary. See the Evidence of Coverage for more information regarding Select Insulins, including full cost-sharing information.

Extra Benefits
In addition to comprehensive medical, hospital and Part D prescription drug coverage, Essence plans also include many valuable extras not offered by Original Medicare or Medicare supplements at no additional cost to you—just another way of helping you stay healthy while saving you money.
Learn MoreImportant Plan Documents
- Summary of Benefits (Updated: 10/14/2021)
- Resumen de Beneficios (Actualizado: 14/10/2021)
- 福利摘要 (更新日期:2021 年 10 月 14 日)
- Evidence of Coverage (Updated: 12/23/2021)
- Evidencia de Cobertura (Actualizado: 23/12/2021)
- 承保范围的证据 (更新日期:2021 年 12 月 23 日)
- Star Rating Sheet (Updated: 10/26/2021)
- Calificaciones por Estrellas (Actualizado: 26/10/2021)
- Provider Directory (Updated: 04/06/2022)
- Directorio de Proveedores (Actualizado: 06/04/2022)
- 提供商目录 (更新時間:2022 年 4 月 6 日)
- Annual Notice of Change (Updated: 09/17/2021)
- Aviso Anual de Cambio (Actualizado: 30/09/2021)
- 年度变更通知 (更新日期:2021 年 9 月 30 日)
- Drug Formulary (Updated: 02/22/2022)
- Formulario de Medicamentos (Actualizado: 22/03/2022)
- 药物配方 (更新時間:2022 年 3 月 22 日)
- Low Income Subsidy Information
- Información sobre Subsidios por Bajos Ingresos
- 低收入补贴信息
Ready to get the all-in-one coverage of an Essence Healthcare plan?
We make it easy for you to get the information you need, when and how you need it.
Request your FREE Information Kit
Download your FREE Medicare Advantage info kit or request a copy by mail.
Schedule a one-on-one consultation
Get all your questions answered in a one-on-one appointment with a licensed Medicare advisor.
Attend a Medicare Seminar
Learn more about Essence Healthcare plans at one of our FREE local or online Medicare seminars.
Talk with a licensed Medicare advisor
Call anytime to discuss your options with a local, licensed Essence Healthcare advisor.