Health Alliance Medicare HMO 20 Rx (HMO)
Indiana Medicare Advantage Plan (2024 Plan)
by Health Alliance Medicare
Additional Coverage
HearingVisionDental
Overall Government Star Rating
4.0
out of 5 stars
Plan Name
Health Alliance Medicare HMO 20 Rx (HMO)
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Health Alliance Medicare HMO 20 Rx (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Indiana 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
$10 copay per visit
Specialist visit
$40 copay per visit
ER visit
$120 copay per visit (always covered)
Health Alliance Medicare HMO 20 Rx (HMO) has a monthly premium cost of $125 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $4,000 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 HMO 20 Rx (HMO) are defined below.
Yes
Part D Prescription Drug Coverage
Health Alliance Medicare HMO 20 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 HMO 20 Rx (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Health Alliance Medicare HMO 20 Rx (HMO) includes coverage for the following additional benefits:
Other benefits
Over the counter drug benefits
Home and bathroom safety devices
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 2024, Health Alliance Medicare HMO 20 Rx (HMO) received an overall government quality rating of 4.0 stars out of 5 stars.
Health Alliance Medicare HMO 20 Rx (HMO) performed the same as Indiana’s State average overall quality score of 4.0 stars.
This Plan’s 5-star Gov’t Quality Score
Indiana State Average Score
Overall Government 5 Star Quality Rating
4.0
4.0
Summary rating of health plan quality
Staying healthy: screenings, tests, & vaccines
Managing chronic (long term) conditions
Member experience with health plan
Member complaints & changes in the health plan's performance
Health plan customer service
Summary rating of drug plan quality
Drug plan customer service
Member complaints & changes in the drug plan's performance
Member experience with the drug plan
Drug safety & accuracy of drug pricing
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.
Health Alliance Medicare HMO 20 Rx (HMO) received 4 stars for its health plan quality score which is the same as the Indiana State average health plan quality score of 4.0 stars.
Health Alliance Medicare HMO 20 Rx (HMO) received 4 stars for its drug plan quality score which is better than the Indiana State average drug plan quality score of 3.8 stars.
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
$120 copay per visit (always covered)
Urgent care
$40 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
$250 per day for days 1 through 8
$0 per day for days 9 through 90
Outpatient hospital coverage
Skilled nursing facility
Skilled nursing facility
$0 per day for days 1 through 20
$203 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 | Gap coverage phase1 | Catastrophic coverage phase |
---|
Preferred Generic | $2.00 copay | $2.00 copay |
Generic drugs :
$0 copay Brand-name drugs :
$0 copay |
Generic | $15.00 copay | |
Preferred Brand | $47.00 copay | |
Non-Preferred Drug | 50% | |
Specialty Tier | 33% | |
1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. |
Part B Drugs
Hearing
Preventive Dental
Comprehensive dental
Prosthodontics, other oral/maxillofacial surgery, other services
Vision
Eyeglasses (frames & lenses)
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