$0 medicare advantage plan

Experience Health Medicare AdvantageSM (HMO) 2024 benefits include:

  • $0 monthly premium
  • $0 medical deductible
  • $0 drug deductible
  • $0 primary care copay
  • $0 copays for commonly prescribed drugs
  • $0 SilverSneakers® fitness membership
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This $0 premium plan comes with value‑added extras:

Care Support

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Dental Reimbursement

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OTC Allowance

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Routine Eye Exam

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Silversneakers® fitness membership

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Eyewear Allowance

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Meals Program

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Mental Health

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Hearing Exam/Hearing Aids

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Acupuncture

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Worldwide Travel Coverage

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Transportation Services

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In-home Assistance

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Personal Emergency Response System (PERS)

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Home Safety Devices

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This 2024 plan is everything you want in a Medicare plan and more, including a $0 monthly premium, a long list of valuable extras and low Maximum Out-of-Pocket costs to help protect your savings.

2024 Plan Highlights Experience Health Medicare Advantage (HMO)
Monthly Plan Premium $0
Maximum Out-of-Pocket Amount $3,500 per calendar year (in-network covered hospital and medical services)
Please note that you’ll still need to pay your Part D prescription drug cost-share.
Doctor and Hospital Visits
Primary Care Doctor $0 copay per visit
Specialist $20 copay per visit with NO REFERRALS
Physical Therapy $20 copay per visit
Mental Health Service $0 copay Outpatient individual/group therapy visit
Urgent Care $60 copay per visit. This coverage is worldwide.
Emergency Room Visit $120 copay per visit. This coverage is worldwide.
Outpatient Hospital $200 copay per visit
Inpatient Hospital $295 per day for days 1 – 6; $0 for days 7 and beyond
Skilled Nursing Facility $0 per day for days 1 – 20; $203 per day for days 21 – 45; $0 per day for days 46 – 100
Ambulance Services $295 copay. This coverage is worldwide.
Diagnostics and Supplies
Outpatient Services:
Performed in PCP setting $0 copay
Performed in any other setting:
Lab Services $8 copay
X-rays (Outpatient) $10 copay
Diagnostic Procedures/Tests $20 copay
Diagnostic Radiology Scans $75 copay – CT Scan; $100 copay – MRI;
$150 copay – PET
Therapeutic Radiology Services (such as radiation for cancer) 20% copay
Durable Medical Equipment 20% of cost
Diabetic Supplies $0 copay
Insulin $35 copay for on-formulary insulins
Medicare Part B Drugs (including chemotherapy) 0 – 20% of cost
Additional Benefits
SilverSneakers® Fitness Program $0 copay
Dental Reimbursement Allowance $500 annual preventive coverage and $1,500 annual comprehensive coverage
Routine Eye Exam $0 copay
Eyewear Allowance (contacts, eyeglasses, eyeglass frames, eyeglass lenses) $300 per calendar year
OTC Up to $600 per calendar year (up to $150 per quarter)
Meals Program $0 copay for up to 20 home-delivered meals after an inpatient hospitalization
Acupuncture $50 reimbursement allowance per visit for up to 20 visits per year. $20 visits for chronic lower back pain.
Hearing Exam/
Hearing Aids
$0 copay for routine exam;
$599 – $899 copay per hearing aid
Transportation $0 copay for up to 12 one-way trips to or from approved health care locations per year
Personal Emergency Response System (PERS) $0 copay for a medical alert system (wristband and pendant options). Your medical alert system will give you the help you need at the push of a button.
In-Home Assistance $0 copay for up to 6 hours of in-home assistance per month. Members can get assistance with tasks such as meal preparation, bathing, grooming, medication reminders, light housekeeping, and transportation.
Home Safety Devices $0 copay for up to two products per year. Contact plan for an approved list of products.
Prescription Drug Benefits Standard Retail (30‑Day Supply) Preferred
Mail Order (90‑Day Supply)
Standard
Mail Order (90‑Day Supply)
Tier 1: Preferred Generic $0 copay $0 copay $0 copay
Tier 2: Generic $5 copay $12.50 copay $15 copay
Tier 3: Preferred Brand $45 copay $112.50 copay $135 copay
Tier 4: Non-Preferred Drug $99 copay $247.50 copay $297 copay
Tier 5: Specialty 33% coinsurance N/A N/A
Tier 6: Select Care Drugs $0 copay $0 copay $0 copay