Anthem I MaineHealth Advantage Plus (HMO)
Maine Medicare Advantage Plan (2024 Plan)
Overall Government Star Rating3.5
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Anthem I MaineHealth Advantage Plus (HMO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Maine and offered by the health insurance company AMH Health. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Anthem I MaineHealth Advantage Plus (HMO) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,350 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 Anthem I MaineHealth Advantage Plus (HMO) are defined below.
Additional Benefits and Coverage
Anthem I MaineHealth Advantage Plus (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. Anthem I MaineHealth Advantage Plus (HMO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. Anthem I MaineHealth Advantage Plus (HMO) includes coverage for the following additional benefits:
Comparing the Quality Score of Anthem I MaineHealth Advantage Plus (HMO) to Other Plans in Maine
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, Anthem I MaineHealth Advantage Plus (HMO) received an overall government quality rating of 3.5 stars out of 5 stars.
Anthem I MaineHealth Advantage Plus (HMO) performed worse than Maine’s State average overall quality score of 4.0 stars.
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.
Anthem I MaineHealth Advantage Plus (HMO) received 3.5 stars for its health plan quality score which is worse than the Maine State average health plan quality score of 3.9 stars.
Anthem I MaineHealth Advantage Plus (HMO) received 4 stars for its drug plan quality score which is better than the Maine State average drug plan quality score of 3.9 stars.
Plan Benefits and Coverage Details
Tests, labs, & imaging
$0 per day for days 8 through 90
Skilled nursing facility
$175 per day for days 21 through 100
Mental health services
Opioid treatment services
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
|Tiers||Initial coverage phase||Gap coverage phase1||Catastrophic coverage phase|
|Preferred Generic||$9.00 copay||$0 copay|
|Generic||$15.00 copay||$0 copay|
|Preferred Brand||$35.00 copay||$0 copay|
|Non-Preferred Drug||$100.00 copay||$0 copay|
|Specialty Tier||33%||$0 copay|
|1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs.|
Part B Drugs
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In this article we rank Maine Medicare Advantage plans based on our evaluation of government 5-star quality scores. Each year the government rates the quality of Medicare Advantage health insurance plans with a 5-star quality score. An overall quality score is assigned to each plan which is based on the scores of various quality metrics.
The Medicare landscape in Maine is constantly changing. In this article we show a summary of new and returning health insurance companies offering Medicare Advantage Plans (Part C) and Medicare Prescription Drug Plans (Part D) in Maine.