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Read more →Anthem I MaineHealth Advantage Veteran (PPO)
by AMH Health
2026 Medicare Advantage plan available in Maine
Plan ID H9219-004-0
Additional coverage:
HearingVisionDental
Medicare Advantage PPO $0 premium
Monthly plan premium $0 / mo
Annual deductible $750 / yr
Max out-of-pocket · in-network $7,200 / yr
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Plan Overview
Anthem I MaineHealth Advantage Veteran (PPO) is a Medicare Advantage Plan Without Prescription Drugs, which is available in Maine and offered by the health insurance company AMH Health. This plan's network type is PPO, which determines the in-network doctors who accept the plan and whether a referral is needed.
Plan Name Anthem I MaineHealth Advantage Veteran (PPO)
Insurance Carrier AMH Health
Plan Type Medicare Advantage Plan Without Prescription Drugs
Network Type PPO
Cost Summary
Anthem I MaineHealth Advantage Veteran (PPO) has a monthly premium cost of $0 per month, with an annual deductible of $750 annual deductible and a maximum out-of-pocket cost sharing of $7,200. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $0 / mo
Annual Deductible $750 annual deductible / yr
Max Out-of-Pocket · in-network $7,200 / yr
Primary doctor visit $0 copay
Specialist visit $45 copay
ER visit $115 copay
Ambulance $323 copay
Additional Benefits and Coverage
Anthem I MaineHealth Advantage Veteran (PPO) is a Medicare Advantage plan which does not 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 Veteran (PPO) includes coverage for hearing, vision, dental.
Part D Prescription Drug Coverage No
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No
Other benefits
Fitness benefit Limited coverage
Over-the-counter drug benefits Limited coverage
In-home support services Not covered
Home & bathroom safety devices Not covered
Meals for short duration Not covered
Annual physical exams Limited coverage
Telehealth Limited coverage
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Specialist visit In-network: $45 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Tests, labs & imaging
Diagnostic tests & procedures In-network: $0-$140 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Lab services In-network: $0-$15 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Diagnostic radiology services (like MRI) In-network: $50-$350 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient x-rays In-network: $50-$110 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Emergency care $115 copay
Urgent care $40 copay
Hospital Services
Inpatient hospital coverage In-network:
Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
50% per stay
Tier 1
$350 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
50% per stay
Outpatient hospital coverage In-network: $0-$350 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Skilled nursing facility
Skilled nursing facility In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
50% per stay
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
50% per stay
Preventive services
Preventive services In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Ambulance
Ground ambulance In-network: $323 copay
Out-of-network: $323 copay
Out-of-network: $323 copay
Therapy services
Occupational therapy visit In-network: $35 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Physical therapy & speech & language therapy visit In-network: $35 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Mental health services
Outpatient group therapy with a psychiatrist In-network: $45 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient individual therapy with a psychiatrist In-network: $45 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient group therapy visit In-network: $45 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient individual therapy visit In-network: $45 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Diabetes supplies In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Extra Benefits
Hearing
Hearing exam In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Fitting/evaluation In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Hearing aids - prescription In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Hearing aids - over the counter In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Preventive dental
Oral exam In-network: $0 copay
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Fluoride treatment In-network: $0 copay
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 20% coinsurance
Out-of-network: 20% coinsurance
Comprehensive dental
Restorative services In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Endodontics In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Periodontics In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, removable In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, fixed In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Orthodontics Not covered
Adjunctive general services In-network: 25% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Vision
Routine eye exam In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Contact lenses In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Upgrades Not covered
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