Mass General Brigham Advantage Secure (HMO-POS)
Massachusetts Medicare Advantage Plan (2025 Plan)
by Mass General Brigham Health Plan
Additional Coverage
HearingVisionDental
Overall Government Star Rating
(coming soon)
Plan Name
Mass General Brigham Advantage Secure (HMO-POS)
Insurance Carrier
Mass General Brigham Health Plan
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Mass General Brigham Advantage Secure (HMO-POS) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Massachusetts and offered by the health insurance company Mass General Brigham Health Plan. 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
$45 copay per visit
ER visit
$105 copay per visit (always covered)
Mass General Brigham Advantage Secure (HMO-POS) has a monthly premium cost of $52 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $7,000 In and Out-of-network
$3,350 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 Mass General Brigham Advantage Secure (HMO-POS) are defined below.
Yes
Part D Prescription Drug Coverage
Mass General Brigham Advantage Secure (HMO-POS) 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. Mass General Brigham Advantage Secure (HMO-POS) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Mass General Brigham Advantage Secure (HMO-POS) 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
$7,000 In and Out-of-network
$3,350 In-network
Nationwide Coverage included
Hearing Coverage included
Doctor Services
Primary doctor visit
In-network: $0 copay
Out-of-network: $20 copay per visit
Specialist visit
In-network: $45 copay per visit
Out-of-network: $50 copay per visit
Tests, labs, & imaging
Diagnostic tests & procedures
In-network: $20 copay
Out-of-network: 20% coinsurance
Lab services
In-network: $0 copay
Out-of-network: 20% coinsurance
Diagnostic radiology services (like MRI)
In-network: $75-160 copay
Out-of-network: 20% coinsurance
Outpatient x-rays
In-network: $10 copay
Out-of-network: 20% coinsurance
Emergency care
$105 copay per visit (always covered)
Urgent care
$50 copay per visit (always covered)
Hospital Services
Inpatient hospital coverage
In-network: $250 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: 30% per stay
Outpatient hospital coverage
In-network: $0-200 copay per visit
Out-of-network: 30% coinsurance per visit
Skilled nursing facility
Skilled nursing facility
In-network: $0 per day for days 1 through 20
$160 per day for days 21 through 44
$0 per day for days 45 through 100
Out-of-network: 30% per stay
Preventive services
Preventive services
In-network: $0 copay
Out-of-network: $0 copay
Ambulance
Ground ambulance
In-network: $200 copay
Out-of-network: $200 copay
Therapy services
Occupational therapy visit
In-network: $15 copay
Out-of-network: $50 copay
Physical therapy & speech & language therapy visit
In-network: $15 copay
Out-of-network: $50 copay
Mental health services
Outpatient group therapy with a psychiatrist
In-network: $20 copay
Out-of-network: $50 copay
Outpatient individual therapy with a psychiatrist
In-network: $20 copay
Out-of-network: $50 copay
Outpatient group therapy visit
In-network: $20 copay
Out-of-network: $50 copay
Outpatient individual therapy visit
In-network: $20 copay
Out-of-network: $50 copay
Opioid treatment services
Opioid treatment services
Other services
Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Out-of-network: 20% coinsurance per item
Diabetes supplies
In-network: $0 copay
Out-of-network: 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 | $0.00 copay | $0 copay |
| Generic | $5.00 copay | $0 copay |
| Preferred Brand | $47.00 copay | $0 copay |
| Non-Preferred Drug | $100.00 copay | $0 copay |
| Specialty Tier | 33% coinsurance | $0 copay |
Part B Drugs
Chemotherapy drugs
In-network: 0-20% coinsurance
Out-of-network: 20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance
Out-of-network: 20% coinsurance
Hearing
Hearing exam
In-network: $45 copay
Out-of-network: $50 copay
Hearing aids - All types
In-network: $699-999 copay
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: $0 copay
Out-of-network: 20% coinsurance
Endodontics
In-network: $0 copay
Out-of-network: 20% coinsurance
Periodontics
In-network: $0 copay
Out-of-network: 20% coinsurance
Prosthodontics, removable
In-network: $0 copay
Out-of-network: 20% coinsurance
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: 20% coinsurance
Maxillofacial prosthetics
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: 20% coinsurance
Adjunctive general services
In-network: $0 copay
Out-of-network: $0 copay
Vision
Routine eye exam
In-network: $0 copay
Out-of-network: $0 copay
Contact lenses
In-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: $0 copay
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