CDPHP Core

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

Core HMO¹
Monthly Premium² $15*
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 Copayment² $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 in the U.S. for all dental services, routine cleaning/restorative/dentures (not to be used for teeth whitening): $1,500
Vision: Annual Routine Eye Exam $0
Frames/Lenses on a prepaid Benefits Mastercard (per year) $250
Hearing Care Solutions Hearing Aid Benefit (per ear) $199 or $499
Over-the-counter Benefit $100 / 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) Information
View a side-by-side comparison Medicare Advantage Plan Options

Core HMO¹

Monthly Premium²

$15*

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 Copayment²

$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 in the U.S. for all dental services, routine cleaning/restorative/dentures (not to be used for teeth whitening):

$1,500

Vision: Annual Routine Eye Exam

Frames/Lenses on a prepaid Benefits Mastercard (per year)

$250

Hearing Care Solutions Hearing Aid Benefit (per ear)

$199 or $499

Over-the-counter Benefit

$100 / 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) Information

View a side-by-side comparison

Medicare Advantage Plan Options

*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 Core

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Could a Medicare Advantage HMO plan be right for you?