Health Alliance Medicare Guide HMO Rx (HMO)
Iowa Medicare Advantage Plan (2025 Plan)
by Health Alliance Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Name
Health Alliance Medicare Guide HMO Rx (HMO)
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Health Alliance Medicare Guide HMO Rx (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Iowa and offered by the health insurance company Health Alliance Medicare. 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
$40 copay per visit
ER visit
$125 copay per visit (always covered)
Health Alliance Medicare Guide HMO Rx (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 $4,300 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 Health Alliance Medicare Guide HMO Rx (HMO) are defined below.
Yes
Part D Prescription Drug Coverage
Health Alliance Medicare Guide HMO Rx (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. Health Alliance Medicare Guide HMO Rx (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Health Alliance Medicare Guide HMO Rx (HMO) 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
Tests, labs, & imaging
Diagnostic tests & procedures
Diagnostic radiology services (like MRI)
Emergency care
$125 copay per visit (always covered)
Urgent care
$55 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
$275 per day for days 1 through 10
$0 per day for days 11 through 90
Outpatient hospital coverage
Skilled nursing facility
Skilled nursing facility
$10 per day for days 1 through 20
$214 per day for days 21 through 100
Preventive services
Ambulance
Therapy services
Occupational therapy visit
Physical therapy & speech & language therapy visit
Mental health services
Outpatient group therapy with a psychiatrist
Outpatient individual therapy with a psychiatrist
Outpatient group therapy visit
Outpatient individual therapy visit
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
0-20% coinsurance per item
Prosthetics (like braces, artificial limbs)
Diabetes supplies
0-20% coinsurance per item
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
Tiers | Initial coverage phase | Catastrophic coverage phase |
---|
Preferred Generic | $2.00 copay | $0 copay |
Generic | $15.00 copay | $0 copay |
Preferred Brand | 25% coinsurance | $0 copay |
Non-Preferred Drug | 50% coinsurance | $0 copay |
Specialty Tier | 33% coinsurance | $0 copay |
Part B Drugs
Hearing
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: 20% coinsurance
Out-of-network: 20% coinsurance
Endodontics
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Periodontics
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Prosthodontics, removable
In-network: 40% coinsurance
Out-of-network: 40% coinsurance
Prosthodontics, fixed
In-network: 40% coinsurance
Out-of-network: 40% coinsurance
Maxillofacial prosthetics
In-network: 40% coinsurance
Out-of-network: 40% coinsurance
Implant services
In-network: 40% coinsurance
Out-of-network: 40% coinsurance
Oral and maxillofacial surgery
In-network: 20% coinsurance
Out-of-network: 20% coinsurance
Adjunctive general services
In-network: 40% coinsurance
Out-of-network: 40% coinsurance
Vision
Eyeglasses (frames & lenses)
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