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  1. IL
  2. Health Alliance Medicare
  3. Plan

Health Alliance Medicare HMO Classic Rx (HMO)

Medicare Plan Details (2023 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) with Prescription Drug (Part D)

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

 

Plan Details

$0
$0
$0
$0
$8,300 In-network
No
Yes
Yes
Yes
http://www.healthalliancemedicare.org
http://www.healthalliancemedicare.org

Medical Benefits

Doctor Services

$35 copay per visit
$50 copay per visit

Tests, labs, & imaging

$40 copay
$0-40 copay
$250 copay
20% coinsurance
$95 copay per visit (always covered)
$60 copay per visit (always covered)

Hospital Services

$300 per day for days 1 through 6
$0 per day for days 7 through 90
25% coinsurance per visit

Skilled nursing facility

$0 per day for days 1 through 20
$196 per day for days 21 through 100

Preventive services

$0 copay

Ambulance

$400 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

Prescription Drug Benefits

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

TiersInitial coverage phaseGap coverage phase1Catastrophic coverage phase
Preferred Generic$2.00 copay$2.00 copay


Generic drugs :
$4.15 copay or 5% (whichever costs more)

Brand-name drugs :
$10.35 copay or 5% (whichever costs more)

Generic$15.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug50%
Specialty Tier31%
1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.

Part B Drugs

20% coinsurance
20% coinsurance

Extra Benefits

Hearing

$25 copay
Not covered
Not covered
Not covered
Not covered

Preventive Dental

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

Comprehensive dental

20% coinsurance
$0 copay
20% coinsurance
20% coinsurance
20% coinsurance
20% coinsurance
20-40% coinsurance

Vision

$0 copay
Not covered
Not covered
Not covered
Not covered
Not covered

Other benefits

Limited coverage
Limited coverage
Limited coverage
Not covered
Limited coverage
Limited coverage
Limited coverage

Health Plan Star Ratings

(government star ratings are out of 5 stars)
 4.5
 4
 3
 5
 5
 4

Prescription Drug Plan Star Ratings

(government star ratings are out of 5 stars)
 3.5
 5
 4
 3
 4

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.

 

 

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