Health Alliance Medicare HMO Basic (HMO)

Medicare Plan Details (2022 Plan)


Monthly Premium

 

by Health Alliance Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 4.0
out of 5 stars

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Plan Type

Medicare Advantage (Part C)

Medicare Advantage combines Part A and Part B. This plan = Part A + Part B

 

$0
$0
$0
$0
$6,700 In-network
No
Yes
Yes
Yes

Doctor Services

$10 copay per visit
$45 copay per visit

Tests, labs, & imaging

20% coinsurance
0-20% coinsurance
$150 copay
20% coinsurance
$90 copay per visit (always covered)
$65 copay per visit (always covered)

Hospital Services

$300 per day for days 1 through 6
$0 per day for days 7 through 90
20% coinsurance per visit

Skilled nursing facility

$0 per day for days 1 through 20
$188 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$275 copay

Therapy services

$40 copay
$40 copay

Mental health services

$40 copay
$40 copay
$40 copay
$40 copay

Opioid treatment services

Covered

Other services

0-20% coinsurance per item
20% coinsurance per item
0-20% coinsurance per item

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

Part B Drugs

20% coinsurance
20% coinsurance

Hearing

$25 copay
$0 copay
$699-999 copay

Preventive Dental

$0 copay
$0 copay
$0 copay
$0 copay

Comprehensive dental

20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
20-50% coinsurance

Vision

$0 copay
$0 copay
$0 copay
$0 copay
$0 copay
$0 copay

Other benefits

Limited coverage
Not covered
Not covered
Not covered
Limited coverage
Limited coverage
Limited coverage
 4
 4
 3
 5
 4
 4

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