Health Alliance Medicare POS Basic (HMO-POS)

Medicare Plan Details

2020 Plan

Monthly Premium

(select county for price)

by Health Alliance Medicare

Additional Coverage

Hearing Vision Dental

Overall Government Star Rating

3.5

out of 5 stars

State: Illinois

Select your county to view the price for this plan

Plan Type

Medicare Advantage (Part C)

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

Monthly Premium

$23

Health Portion of Premium

$23

Drug Portion of Premium

Health Plan Deductible

Health Plan Max Out-of-Pocket

$10,000 In and Out-of-network
$6,700 In-network

Nationwide Coverage included

Hearing Coverage included

Yes

Vision Coverage included

Yes

Dental Coverage included

Yes

Doctor Lookup Link

http://www.healthalliancemedicare.org

Plan Link

http://www.healthalliancemedicare.org

Medical Benefits

Doctor Services

Primary doctor visit

In-network: $35 per visit
Out-of-network: $50 per visit

Specialist visit

In-network: $50 per visit
Out-of-network: $65 per visit

Tests, labs, & imaging

Diagnostic tests & procedures

In-network: $40
Out-of-network: $50

Lab services

In-network: $40
Out-of-network: $50

Diagnostic radiology services (like MRI)

In-network: $40
Out-of-network: $50

Outpatient x-rays

In-network: $40
Out-of-network: $50

Emergency care

$90 per visit (always covered)

Urgent care

$65 per visit (always covered)

Hospital Services

Inpatient hospital coverage

In-network: $450 per day for days 1 through 4
$0 per day for days 5 through 90
Out-of-network: $600 per day for days 1 through 6
$0 per day for days 7 through 90

Outpatient hospital coverage

In-network: 25% per visit
Out-of-network: 25% per visit

Skilled nursing facility

In-network: $0 per day for days 1 through 20
$178 per day for days 21 through 100
Out-of-network: $100 per day for days 1 through 20
$200 per day for days 21 through 100

Preventive services

In-network: $0 copay
Out-of-network: $50

Ambulance

Ground ambulance

In-network: $350
Out-of-network: No Data

Therapy services

Occupational therapy visit

In-network: $40
Out-of-network: $50

Physical therapy & speech & language therapy visit

In-network: $40
Out-of-network: $50

Mental health services

Outpatient group therapy with a psychiatrist

In-network: $40
Out-of-network: $50

Outpatient individual therapy with a psychiatrist

In-network: $40
Out-of-network: $50

Outpatient group therapy visit

In-network: $40
Out-of-network: $50

Outpatient individual therapy visit

In-network: $40
Out-of-network: $50

Opioid treatment services

Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)

In-network: 0-20% per item
Out-of-network: 20% per item

Prosthetics (like braces, artificial limbs)

In-network: 20% per item
Out-of-network: 20% per item

Diabetes supplies

In-network: $0 copay
Out-of-network: 20% per item

Prescription Drug Benefits

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

Part B Drugs

Chemotherapy drugs

In-network: 20%
Out-of-network: 20%

Other Part B drugs

In-network: 20%
Out-of-network: 20%

Extra Benefits

Hearing

Hearing exam

In-network: $25
Out-of-network: $40

Fitting/evaluation

Not covered

Hearing aids - All types

In-network: $699-999
Out-of-network: No Data