You are viewing services for 2024 Medicare Advantage Coverage
Speak with a Medicare Advantage advisor at (866) 350-2715
Your health is important to us, and we’re proud to offer a choice of Memorial Hermann Medicare Advantage Plans that give you the comprehensive coverage you need along with the high-quality, local care you deserve.
For a quick glance at our available Memorial Hermann Medicare Advantage HMO Plans, see the comparison chart below. If you are eligible for both Medicare and Medicaid, you may qualify for the Memorial Hermann Dual Advantage Special Needs Plan (D-SNP). To learn more, visit the D-SNP section of our website.
Benefits & Features* | Memorial Hermann Advantage HMO |
Memorial Hermann Advantage Golden Triangle HMO |
Memorial Hermann Advantage Prime Value MA-Only HMO |
---|---|---|---|
County Availability | Harris, Montgomery, Fort Bend, Brazoria, Galveston, Liberty | Jefferson, Hardin | Harris, Montgomery, Fort Bend, Brazoria, Galveston, Liberty |
Monthly Plan Premium | $0 | $0 | $0 |
Maximum Out of Pocket (MOOP) | $2,950 | $3,200 | $2,950 |
In-Hospital Copay | $350 per Stay | $350 per Stay | $500 per Stay |
Copay for Primary Care Physician (PCP) | $0 | $0 | $0 |
Copay for In-Network specialist (with no PCP referral needed) | $15 | $20 | $30 |
Prescription Drug (Part D) Coverage – at no additional cost | Yes | Yes | No |
Copay for 90-day mail order of Tier 1 preferred generic drugs | $0 | $0 | N/A |
Prescription Drug Deductible | $0 | $0 | N/A |
Fitness Benefits and Wellness Program – at no extra cost | Yes | Yes | Yes |
Vision and Hearing Coverage | Yes | Yes | Yes |
Dental Benefit1 | Yes | Yes | Yes |
National/worldwide urgent care and emergency coverage | Yes | Yes | Yes |
Convenient Virtual Care options such as Teladoc and the Memorial Hermann Virtual Care | Yes | Yes | Yes |
Over-the-Counter Benefit2 | Yes | Yes | Yes |
Transportation Benefit3 | Yes | Yes | Yes |
Meal Benefit4 | Yes | Yes | Yes |
Flex Card5 | Yes | Yes | Yes |
1 For the Dental Benefit, the DHMO (Liberty Dental Plan® Health Maintenance Organization) provides services on the Memorial Hermann Medicare Advantage HMO Plan. To learn more about the dental benefits offered with your specific plan, click here or visit Liberty Dental Plan. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
2 For the Over-the-Counter Benefit available for all plans, Medline At Home provides over-the-counter products covered under your specific plan at no additional cost to you.
3 For Transportation Benefit available on all plans. Click here for more information or visit ModivCare to schedule a ride. (Please note that by clicking on this link, you will be leaving Memorial Hermann Advantage website.)
4 For Meal Benefit available on all plans, offers members 10 meals post-discharge of an in-patient hospitalization stay. Service must be requested within 14 days of discharge. Click here for more information on this benefit.
5 For Flex Card Members can use their flex card to cover costs associated with supplemental benefits including Vision, Hearing, OTC and Grocery where applicable. (D-SNP plans and those who have been enrolled in Case Management and approved by a Case Manager will receive a grocery benefit) Click here for more information.
*If you are eligible for both Medicare and Medicaid, you may qualify for the Memorial Hermann Dual Advantage Special Needs Plan (D-SNP). To learn more, please visit the D-SNP section of our website.
*You must continue to pay your Medicare Part B premium. Benefits and features vary by plan. This information is not a complete description of benefits. Call Customer Service at (855) 645-8448 (TTY 711) for more information. Their hours of operation are 8 a.m. to 8 p.m. CT, 7 days a week from Oct. 1 – March 31 and 8 a.m. to 8 p.m. CT, Monday – Friday from April 1 – Sept. 30.
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