All of our Medicare Advantage plans feature a $0 copay for primary care visits and $0-15 copay for urgent care visits.*
Plans include the same medical benefits as Original Medicare Parts A and B (medical and hospital insurance), plus additional coverage for other health needs. For example:
- Inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care (Part A)
- Certain doctors’ services, outpatient care, medical supplies, and preventive services (Part B)
- Other areas of your health and alternative medicine options, like acupuncture and naturopathy
Medical Services:
- Hospital and medical insurance (Medicare Part A & B)
- Primary care
- Specialist care
- Lab services
- Urgent care and emergency care
- Ambulance services
- Diabetic supplies
- Podiatry
- Chiropractic
- Acupuncture
- Naturopathy
- Massage
Doctor Visits:
- Primary and preventive care visits
- Urgent care visits
- Virtual Care/Telehealth
- Specialist appointments with an in-network provider
- Physical therapy
Diagnostic Services:
- Radiology
- Tests and procedures outside of preventive tests
- Lab services
- Outpatient x-ray
- Therapeutic radiology services (such as radiation treatment for cancer)
Medical Benefits by Medicare Advantage (MA) Plan
2023 MA Plans
| MA Dual Plan (HMO SNP)* | Primary Care (per visit): $0 to 20%
Specialist Care (per visit) $0 to 20% Medicare-covered Lab Services: $0 to 20% Urgent Care (per visit): $0 to 20%; $60 limit Emergency Care (per visit): $0 to 20%; $95 limit Diabetic Supplies: $0 to 20% Chiropractic (per Medicare-covered visit): $0 to 20% Alternative Medicine: $0 copay for 25 visits/year for acupuncture, naturopathy, massage, non-Medicare chiropractic combined Out-of-pocket Maximum: $8,300 per calendar year |
| MA Plan 1 (HMO) | Primary Care (per visit): $0 copay
Specialist Care (per visit): $50 copay Medicare-covered Lab Services: $0 copay Urgent Care (per visit): $15 copay Emergency Care (per visit): $95 copay, copay waived if admitted Diabetic Supplies: $0 Chiropractic (per Medicare-covered visit): $20 copay Alternative Medicine: $0 copay for 12 visits/year for acupuncture, naturopathy, massage, non-Medicare chiropractic combined Out-of-pocket Maximum: $7,900 per calendar year |
| MA Plan 2 (HMO) | Primary Care (per visit): $0 copay
Specialist Care (per visit) $40 copay Medicare-covered Lab Services: $0 copay Urgent Care (per visit): $10 copay Emergency Care (per visit): $95 copay, copay waived if admitted Diabetic Supplies: $0 Chiropractic (per Medicare-covered visit): $20 copay Alternative Medicine: $0 copay for 12 visits/year for acupuncture, naturopathy, massage, non-Medicare chiropractic combined Out-of-pocket Maximum: $7,900 per calendar year |
| MA Plan 3 (HMO) | Primary Care (per visit): $0 copay
Specialist Care (per visit) $40 copay Medicare-covered Lab Services: $0 copay Urgent Care (per visit): $0 copay Emergency Care (per visit): $95 copay, copay waived if admitted Diabetic Supplies: $0 Chiropractic (per Medicare-covered visit): $20 copay Alternative Medicine: $0 copay for 12 visits/year for acupuncture, naturopathy, massage, non-Medicare chiropractic combined Out-of-pocket Maximum: $7,900 per calendar year |
| MA Plan 4 (HMO) | |
| MA Freedom Plan (HMO) |
*For most services, Dual Plan members pay a $0 copay or 20%. The amount you pay depends on the level of state Medicaid (Apple Health) assistance you receive. Our local Medicare experts can tell you what your share (if any) of the service costs will be: 1-800-944-1247 (TTY: 711).
We’re here to help.
To ask questions, request print copies of materials, and more, contact Customer Service at 1-800-942-0247 (TTY: 711), 8:00 a.m. to 8:00 p.m., 7 days a week.
Did you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.
