PrimeTime Health Plan Aultimate (HMO-POS)

Ohio Medicare Advantage Plan (2025 Plan)


Monthly Premium

Your Cost
$0
by PrimeTime Health Plan

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 4.5
out of 5 stars

Ready to Enroll Online?


Plan Name
PrimeTime Health Plan Aultimate (HMO-POS)
Insurance Carrier
PrimeTime Health Plan
Plan Type
Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type
HMO

PrimeTime Health Plan Aultimate (HMO-POS) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Ohio and offered by the health insurance company PrimeTime 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.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$4,300
Primary doctor visit
$0 copay
Specialist visit
$40 copay per visit
ER visit
$110 copay per visit (always covered)
Ambulance
$230 copay

PrimeTime Health Plan Aultimate (HMO-POS) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $4,300 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 PrimeTime Health Plan Aultimate (HMO-POS) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

PrimeTime Health Plan Aultimate (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. PrimeTime Health Plan Aultimate (HMO-POS) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. PrimeTime Health Plan Aultimate (HMO-POS) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Limited coverage
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Not covered
Telehealth
Limited coverage

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 2025, PrimeTime Health Plan Aultimate (HMO-POS) received an overall government quality rating of 4.5 stars out of 5 stars.

PrimeTime Health Plan Aultimate (HMO-POS) performed better than Ohio’s State average overall quality score of 3.9 stars.

This Plan’s 5-star Gov’t Quality Score
Ohio State Average Score
Overall Government 5 Star Quality Rating
 4.5
 3.9
Summary rating of health plan quality
 5
 3.9
Staying healthy: screenings, tests, & vaccines
 4
 3.5
Managing chronic (long term) conditions
 3
 3.3
Member experience with health plan
 5
 4.2
Member complaints & changes in the health plan's performance
 5
 4.2
Health plan customer service
 5
 4.0
Summary rating of drug plan quality
 4.5
 3.9
Drug plan customer service
 4
 4.0
Member complaints & changes in the drug plan's performance
 4
 4.1
Member experience with the drug plan
 5
 4.0
Drug safety & accuracy of drug pricing
 4
 3.4

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.

PrimeTime Health Plan Aultimate (HMO-POS) received 5 stars for its health plan quality score which is better than the Ohio State average health plan quality score of 3.9 stars.

PrimeTime Health Plan Aultimate (HMO-POS) received 4.5 stars for its drug plan quality score which is better than the Ohio State average drug plan quality score of 3.9 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$4,300 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
In-network: $0 copay
Specialist visit
In-network: $40 copay per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $125 copay
Lab services
In-network: $0 copay
Out-of-network: $0 copay
Diagnostic radiology services (like MRI)
In-network: $250 copay
Outpatient x-rays
In-network: $50 copay
Emergency care
$110 copay per visit (always covered)
Urgent care
$40 copay per visit (always covered)

Hospital Services

Inpatient hospital coverage
In-network: $310 per day for days 1 through 6
$0 per day for days 7 through 90
Out-of-network: Not Applicable
Outpatient hospital coverage
In-network: $350 copay or 25% coinsurance per visit

Skilled nursing facility

Skilled nursing facility
In-network: $0 per day for days 1 through 20
$150 per day for days 21 through 45
$0 per day for days 46 through 100
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay

Ambulance

Ground ambulance
In-network: $230 copay

Therapy services

Occupational therapy visit
In-network: $45 copay
Physical therapy & speech & language therapy visit
In-network: $45 copay

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $40 copay
Outpatient individual therapy with a psychiatrist
In-network: $40 copay
Outpatient group therapy visit
In-network: $40 copay
Outpatient individual therapy visit
In-network: $40 copay

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: 20% coinsurance per item
Prosthetics (like braces, artificial limbs)
In-network: 20% coinsurance per item
Diabetes supplies
In-network: 0-20% coinsurance per item

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

TiersInitial coverage phaseCatastrophic coverage phase
Preferred Generic$10.00 copay$0 copay
Generic$20.00 copay$0 copay
Preferred BrandGreater of 20% coinsurance and $47.00 copay$0 copay
Non-Preferred Drug50% coinsurance$0 copay
Specialty Tier33% coinsurance$0 copay

Part B Drugs

Chemotherapy drugs
In-network: 0-20% coinsurance
Other Part B drugs
In-network: 0-20% coinsurance

Hearing

Hearing exam
In-network: $25 copay
Fitting/evaluation
Not covered
Hearing aids - All types
In-network: $595-895 copay
Out-of-network: $0 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: $0 copay
Endodontics
In-network: $0 copay
Out-of-network: $0 copay
Periodontics
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, removable
In-network: $0 copay
Out-of-network: $0 copay
Prosthodontics, fixed
In-network: $0 copay
Out-of-network: $0 copay
Maxillofacial prosthetics
In-network: $0 copay
Out-of-network: $0 copay
Implant services
In-network: $0 copay
Out-of-network: $0 copay
Oral and maxillofacial surgery
In-network: $0 copay
Out-of-network: $0 copay
Orthodontics
In-network: $0 copay
Out-of-network: $0 copay
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
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
Not covered

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.

 

 


Ready to Enroll Online?

Please Support Our Sponsor

Advertisement

Medicare Health Plans

Get Advice & Sign Up Help

TTY 711

Speak with a Licensed Insurance Agent

Mon-Fri: 8am - 9pm ET
Sat: 8am - 8pm ET

Medicare65quote

  • Medicare Advantage Plans
  • Medicare Prescription Drug Plans
  • Medicare Supplement Insurance Plans

No obligation to enroll. Find your plan online or speak with a licensed insurance agent to get help signing up for the right plan for you! See www.medicare65quote.com for our Third-Party Marketing Organization disclaimer.
Insurance Ad -No Government Affiliation

Related Articles
Best Ohio Medicare Advantage Health Insurance Companies for 2025

In this article we rank Ohio 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.

Read more →