Gold Loyalty (HMO-POS)
Florida Medicare Advantage Plan (2025 Plan)
by Gold Kidney Health Plan
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Type
Medicare Advantage Plan Without Prescription Drugs
Gold Loyalty (HMO-POS) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Florida and offered by the health insurance company Gold Kidney Health Plan. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Primary doctor visit
$0 copay
Specialist visit
$45 copay per visit
ER visit
$110 copay per visit (always covered)
Gold Loyalty (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $5,500 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. These costs are listed in this summary section and a full list of benefit costs for Gold Loyalty (HMO-POS) are defined below.
No
Part D Prescription Drug Coverage
Gold Loyalty (HMO-POS) is a Medicare Advantage plan which does not include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Gold Loyalty (HMO-POS) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Gold Loyalty (HMO-POS) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
Health Portion of Premium
Health Plan Max Out-of-Pocket
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $0 copay
Specialist visit
In-network: $45 copay per visit
Out-of-network: $45 copay per visit
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Lab services
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Diagnostic radiology services (like MRI)
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Outpatient x-rays
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Emergency care
$110 copay per visit (always covered)
Urgent care
$35 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
In-network: $250 per day for days 1 through 7
$0 per day for days 8 through 90
Out-of-network: $250 per day for days 1 through 7
$0 per day for days 8 through 90
Outpatient hospital coverage
In-network: $0-200 copay per visit
Out-of-network: $0-200 copay per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Out-of-network: $0 per day for days 1 through 20
$214 per day for days 21 through 100
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $275 copay
Out-of-network: $275 copay
Therapy services
Occupational therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Physical therapy & speech & language therapy visit
In-network: $35 copay
Out-of-network: $35 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $25 copay
Out-of-network: $25 copay
Outpatient individual therapy with a psychiatrist
In-network: $45 copay
Out-of-network: $45 copay
Outpatient group therapy visit
In-network: $25 copay
Out-of-network: $25 copay
Outpatient individual therapy visit
In-network: $45 copay
Out-of-network: $45 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Diabetes supplies
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Part B Drugs
Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: $35 copay or 0-20% coinsurance
Hearing
Hearing exam
In-network: $0 copay
Out-of-network: $0 copay
Fitting/evaluation
In-network: $0 copay
Out-of-network: $0 copay
Hearing aids - All types
In-network: $0 copay
Out-of-network: $0 copay
Preventive Dental
Oral exam
In-network: $0 copay
Out-of-network: $0 copay
Cleaning
In-network: $0 copay
Out-of-network: $0 copay
Fluoride treatment
In-network: $0 copay
Out-of-network: $0 copay
Dental x-rays
In-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Restorative services
In-network: $0 copay
Out-of-network: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
In-network: $0 copay
Out-of-network: $0 copay
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
In-network: $0 copay
Out-of-network: $0 copay
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay
Vision
Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only)
In-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only)
In-network: $0 copay
Out-of-network: $0 copay
Upgrades
In-network: $0 copay
Out-of-network: $0 copay
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