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  1. ME
  2. Martin's Point Generations Advantage
  3. Plan

Martin's Point Generations Advantage Value Plus (HMO)

Medicare Plan Details (2023 Plan)

Monthly Premium

 

by Martin's Point Generations Advantage
Additional Coverage
HearingVisionDental
Overall Government Star Rating
 5.0
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
$5,750 In-network
No
Yes
Yes
Yes
http://MartinsPoint.org/Advantage
http://MartinsPoint.org/Advantage

Medical Benefits

Doctor Services

$0-10 copay per visit
$45 copay per visit

Tests, labs, & imaging

0-15% coinsurance
0-20% coinsurance
20% coinsurance
$15 copay
$95 copay per visit (always covered)
$50 copay per visit (always covered)

Hospital Services

$425 per day for days 1 through 5
$0 per day for days 6 through 90
$0-275 copay 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

$325 copay

Therapy services

$40 copay
$40 copay

Mental health services

$25 copay
$25 copay
$25 copay
$25 copay

Opioid treatment services

Covered

Other services

20% coinsurance per item
20% coinsurance per item
$0 copay

Prescription Drug Benefits

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

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic$4.00 copay


Generic drugs :
25%

Brand-name drugs :
25%


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

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

Generic$18.00 copay
Preferred Brand$47.00 copay
Non-Preferred Drug$100.00 copay
Specialty Tier28%

Part B Drugs

20% coinsurance
20% coinsurance

Extra Benefits

Hearing

$45 copay
$0 copay
$495-2,095 copay

Preventive Dental

Covered under office visit
Covered under office visit
Not covered
Covered under office visit

Comprehensive dental

$50 copay or 50% coinsurance
$50 copay or 50% coinsurance
$50 copay or 50% coinsurance
$50 copay or 50% coinsurance
$50 copay or 50% coinsurance
$50 copay or 50% coinsurance
$50 copay or 50% coinsurance

Vision

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

Other benefits

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

Health Plan Star Ratings

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

Prescription Drug Plan Star Ratings

(government star ratings are out of 5 stars)
 5
 5
 5
 5
 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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