2019 Denver Health Medicare Select (HMO) H5608-002-000 in CO from Denver Health Medical Plan | HealthPocket

Denver Health Medicare Select (HMO)

$32/mo

Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderDenver Health Medical Plan
Plan IDH5608-002-000
Plan Year2019
CMS Rating
Plan TypeHMO
Annual Deductible$375.00
Out-of-Pocket Maximum5500

What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2021. see plan

Why We Like This Plan
  • has both Health and Drug Coverage

Costs and Other Important Information

Plan Year2019
Monthly Health Plan Premium$0.00
Monthly Drug Plan Premium$32.00
Health Plan Deductible$185 per year for in-network services.
Other health plan deductibles?No
Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)$5,500 In-network
Optional Supplemental BenefitsNo

Benefits

SERVICECOST
Inpatient hospital coverage$300 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient hospital coverage20% per visit
Doctor visitsPrimary:$10 per visit
Specialist:$30 per visit
Preventive care$0 copay
Emergency care/Urgent careEmergency:$80 per visit (always covered)
Urgent care:$40 per visit (always covered)
Diagnostic procedures/lab services/imagingDiagnostic tests and procedures:20%
Lab services:$0 copay
Diagnostic radiology services (e.g., MRI):20%
Outpatient x-rays:20%
Mental health servicesInpatient hospital - psychiatric:$300 per day for days 1 through 5
$0 per day for days 6 through 90
Outpatient group therapy visit with a psychiatrist:$10
Outpatient individual therapy visit with a psychiatrist:$10
Outpatient group therapy visit:$10
Outpatient individual therapy visit:$10
Skilled Nursing FacilityIn 2019 the amounts for each benefit period are:
$0 copay for days 1 through 20
$170.50 copay per day for days 21 through 100
Rehabilitation servicesOccupational therapy visit:$30
Physical therapy and speech and language therapy visit:$10
Ground ambulance20%
Transportation$0 copay. There may be limits on how much the plan will provide.
Foot care (podiatry services)Foot exams and treatment:$30
Routine foot care:Not covered
Medical equipment/suppliesDurable medical equipment (e.g., wheelchairs, oxygen):20% per item
Prosthetics (e.g., braces, artificial limbs):20% per item
Diabetes supplies:$0 copay
Wellness programs (e.g., fitness, nursing hotline)Covered
Medicare Part B drugsChemotherapy:20%
Other Part B drugs:20%

Benefits Services

Hearing
Hearing exam$30
Fitting/evaluation$30There may be limits on how much the plan will provide.
Hearing aids$0 copay. There may be limits on how much the plan will provide.
Preventive Dental
Oral exam$0 copay. There may be limits on how much the plan will provide.
Cleaning$0 copay. There may be limits on how much the plan will provide.
Fluoride treatmentNot covered
Dental x-ray(s)$0 copay. There may be limits on how much the plan will provide.
Comprehensive Dental
Non-routine servicesNot covered
Diagnostic services$0 copay. There may be limits on how much the plan will provide.
Restorative services$0 copay. There may be limits on how much the plan will provide.
EndodonticsNot covered
Periodontics$0 copay. There may be limits on how much the plan will provide.
Extractions$0 copay
Prosthodontics, other oral/maxillofacial surgery, other servicesNot covered
Vision
Routine eye exam$30There may be limits on how much the plan will provide.
OtherNot covered
Contact lenses$0 copay. There may be limits on how much the plan will provide.
Eyeglasses (frames and lenses)$0 copay. There may be limits on how much the plan will provide.
Eyeglass framesNot covered
Eyeglass lensesNot covered
UpgradesNot covered

Coverage Area for Denver Health Medicare Select (HMO)

StateColorado
CountyDenver

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit


30 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$4 copayNot offered
Tier 2: Non-Preferred GenericNot offereds$10 copayNot offered
Tier 3: Preferred Brand NameNot offereds25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offereds50% coinsuranceNot offered
Tier 5: Specialty TierNot offereds25% coinsuranceNot offered
Tier 6: Select Care DrugsNot offereds$0 copayNot offered

90 Day SupplyPreferred Retail Pharmacies Drug CostStandard Retail Pharmacies Drug CostPreferred Mail-Order Drug CostStandard Mail-Order Drug Cost
Tier 1: Preferred GenericNot offereds$8 copayNot offered
Tier 2: Non-Preferred GenericNot offereds$20 copayNot offered
Tier 3: Preferred Brand NameNot offereds25% coinsuranceNot offered
Tier 4: Non-Preferred Brand NameNot offereds50% coinsuranceNot offered
Tier 5: Specialty Tier
Tier 6: Select Care DrugsNot offereds$0 copayNot offered

Physicians that accept Denver Health Medicare Select (HMO) for Colorado

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Medicare Plans Found

 

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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, or an individual and family health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.