CDPHP Choice | Choice Rx

Could a Medicare Advantage HMO plan be right for you?

Typically HMO plans offer coverage for in-network providers only, with the exception of urgent and emergency care while out of the area. So if you don't receive routine care out of the area, an HMO plan might be a good fit. You'll also need to designate a primary care physician (PCP) to enroll in an HMO plan.

Check out the Medicare Advantage HMO plans listed below to see which one may best fit your needs.

Compare Plans


2023 Medicare HMO Map

Choice HMO and Choice Rx HMO1

Monthly Premium2

Choice: $39.90*

Choice Rx: $128.50

Primary Care Physician Office Visit Copayment

$0

Doctor on Demand

$0

Specialist Office Visit Copayment

$25

Routine Annual Physical Exam Copayment

$0

Urgent Care Copayment

$50 worldwide coverage

Emergency Room Copayment3

$90 worldwide coverage

Ambulance

$165

Outpatient Surgery

$150-$200

Physical Therapy

$25

Inpatient Hospitalization

Days 1-6: $260 per day

Dental reimbursement for All Dental Services
Routine Cleaning/Restorative/Dentures (not for whitening)

$750 reimbursement

Vision: Annual Routine Eye Exam

$0

Frames/Lenses (per year)

$250 reimbursement

Hearing Care Solutions Hearing Aid Benefit

$199 or $499

Over-the-counter Benefit

$75 / quarter

Senior Fit Included

Yes

CDPHP Life Points® Rewards

Earn up to $175

Lab Services

$0 or $5

X-rays

$25

Advanced Imaging Studies (CT, MRI, etc.)

$100

OOP Max

$6,100

Plan Documents

Evidence of Coverage (EOC) and Summary of Benefits (SOB)

*Does not include Rx


Disclaimers:

  1. Must use plan providers

  2. You must continue to pay your Medicare Part B premium; You may qualify for lower premiums with EPIC or Low Income Subsidy

  3. Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.