Premier by Ultimate (HMO)

Florida Medicare Advantage Plan (2025 Plan)


Monthly Premium

Your Cost
$0
by Ultimate Health Plans

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.0
out of 5 stars

Ready to Enroll Online?


Plan Name
Premier by Ultimate (HMO)
Insurance Carrier
Ultimate Health Plans
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
HMO

Premier by Ultimate (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Florida and offered by the health insurance company Ultimate Health Plans. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$3,200
Primary doctor visit
$0 copay
Specialist visit
$25 copay per visit
ER visit
$75 copay per visit (always covered)
Ambulance
$150 copay

Premier by Ultimate (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 $3,200 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 Premier by Ultimate (HMO) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

Premier by Ultimate (HMO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Premier by Ultimate (HMO) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. Premier by Ultimate (HMO) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Not covered
In-home support services
Not covered
Home and bathroom safety devices
Limited coverage
Meals for short duration
Limited coverage
Annual physical exams
Not covered
Telehealth
Limited coverage

Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2025, Premier by Ultimate (HMO) received an overall government quality rating of 4.0 stars out of 5 stars.

Premier by Ultimate (HMO) performed the same as Florida’s State average overall quality score of 4.0 stars.

This Plan’s 5-star Gov’t Quality Score
Florida State Average Score
Overall Government 5 Star Quality Rating
 4.0
 4.0
Summary rating of health plan quality
 4
 4.0
Staying healthy: screenings, tests, & vaccines
 4
 4.0
Managing chronic (long term) conditions
 4
 3.9
Member experience with health plan
 4
 3.9
Member complaints & changes in the health plan's performance
 4
 3.8
Health plan customer service
 4
 4.2
Summary rating of drug plan quality
 4
 3.9
Drug plan customer service
 4
 4.1
Member complaints & changes in the drug plan's performance
 4
 3.6
Member experience with the drug plan
 5
 4.2
Drug safety & accuracy of drug pricing
 4
 3.5

The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.

Premier by Ultimate (HMO) received 4 stars for its health plan quality score which is the same as the Florida State average health plan quality score of 4.0 stars.

Premier by Ultimate (HMO) received 4 stars for its drug plan quality score which is better than the Florida State average drug plan quality score of 3.9 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$3,200 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
$0 copay
Specialist visit
$25 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
$0-150 copay or 0-20% coinsurance
Lab services
$0-150 copay or 0-20% coinsurance
Diagnostic radiology services (like MRI)
$0-150 copay
Outpatient x-rays
$0-150 copay
Emergency care
$75 copay per visit (always covered)
Urgent care
$10 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
$175 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage
$150 copay per visit

Skilled nursing facility

Skilled nursing facility
$0 per day for days 1 through 20
$150 per day for days 21 through 40
$0 per day for days 41 through 100

Preventive services

Preventive services
$0 copay

Ambulance

Ground ambulance
$150 copay

Therapy services

Occupational therapy visit
$30 copay
Physical therapy & speech & language therapy visit
$30 copay

Mental health services

Outpatient group therapy with a psychiatrist
$10 copay
Outpatient individual therapy with a psychiatrist
$25 copay
Outpatient group therapy visit
$10 copay
Outpatient individual therapy visit
$25 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
20% coinsurance per item
Prosthetics (like braces, artificial limbs)
20% coinsurance per item
Diabetes supplies
$0 copay

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$0.00 copay$0 copay
Generic$0.00 copay$0 copay
Preferred Brand$25.00 copay$0 copay
Non-Preferred Drug$75.00 copay$0 copay
Specialty Tier33% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
0-20% coinsurance
Other Part B drugs
0-20% coinsurance

Hearing

Hearing exam
$0 copay
Fitting/evaluation
$0 copay
Hearing aids - All types
$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
Not covered
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
Not covered
Prosthodontics, fixed
Not covered
Maxillofacial prosthetics
Not covered
Implant services
Not covered
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
Not covered
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay

Vision

Routine eye exam
$0 copay
Contact lenses
$0 copay
Eyeglasses (frames & lenses)
$0 copay
Eyeglass frames (only)
$0 copay
Eyeglass lenses (only)
$0 copay
Upgrades
$30-50 copay

When Can I Sign Up for Medicare?

Enter your birthday month and year to learn when you can sign up for different Medicare plan options.

 

 


Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help

TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 9pm ET
Sat: 8am - 8pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.
Insurance Ad -No Government Affiliation

Related Articles
Best Florida Medicare Advantage Health Insurance Companies for 2025

In this article we rank Florida Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.

Read more →