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

Choice HMO and Choice Rx HMO¹
Monthly Premium² Choice: $39.90* Choice Rx: $124
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 $45 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 Allowance on a prepaid Benefits Mastercard to use at any dentist for all dental services, routine cleaning/restorative/dentures (not to be used for teeth whitening): $1,500 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), Summary of Benefits (SOB), and 2023 Inflation Reduction Act Part B Changes
View a side-by-side comparison

Choice HMO and Choice Rx HMO¹

Monthly Premium²

Choice: $39.90*

Choice Rx: $124

Primary Care Physician Office Visit Copayment

Doctor on Demand

Specialist Office Visit Copayment

$25

Routine Annual Physical Exam Copayment

Urgent Care Copayment

$45 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 Allowance on a prepaid Benefits Mastercard to use at any dentist for all dental services,
routine cleaning/restorative/dentures (not to be used for teeth whitening):

$1,500 reimbursement

Vision: Annual Routine Eye Exam

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), Summary of Benefits (SOB), and 2023 Inflation Reduction Act Part B Changes

View a side-by-side comparison

*Does not include Rx

Disclaimers:

Must use plan providers
You must continue to pay your Medicare Part B premium; You may qualify for lower premiums with EPIC or Low Income Subsidy
Copayment waived if admitted to the hospital within 24 hours for the same diagnosis.

CDPHP Choice | Choice Rx

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Could a Medicare Advantage HMO plan be right for you?