Anthem I MaineHealth Advantage Choice (HMO-POS) is a HMO-POS Medicare Advantage (Medicare Part C) plan offered by Anthem I MaineHealth
Plan ID: H9065-003-000
Maine Medicare beneficiaries may want to consider reviewing their Medicare Advantage (Medicare Part C) plan options. A Medicare Advantage plan combines your Original Medicare (Part A and Part B) benefits into a single plan.
Most Medicare Advantage plans cover prescription drugs, and many plans may offer other extra benefits Original Medicare doesn’t cover.
Learn more about Maine Medicare Advantage plans like the one below and find a plan that offers the benefits you want at an affordable price.
|Monthly plan premium||$22.00|
|Initial drug coverage limit||$0.00|
|Catastrophic drug coverage limit||$8,000.00|
|Primary care doctor visit||In-Network:|
|Specialty doctor visit|
|Inpatient hospital care|
40% coinsurance per stay
|Urgent care||Urgent Care: $45.00 copay|
|Emergency room visit||Emergency Care: $90.00 copay|
Worldwide Coverage: This plan covers urgent care and emergency services when traveling outside of the United States for less than six months. This benefit is limited to $100,000.00 per year.
|Ambulance transportation||Ground Ambulance: $300.00 copay Per Trip|
Air Ambulance: 20% coinsurance
Anthem I MaineHealth Advantage Choice (HMO-POS) covers a range of additional benefits. Learn more about Anthem I MaineHealth Advantage Choice (HMO-POS) benefits, some of which may not be covered by Original Medicare (Part A and Part B).
Medicare Covered Chiropractic Services: $20.00 copay
|Diabetes supplies, training, nutrition therapy and monitoring|
|Durable medical equipment (DME)|
|Diagnostic tests, lab and radiology services, and X-rays||In-Network:|
Lab Services: $0.00 copay - $10.00 copay
X-Rays: $35.00 copay - $70.00 copay
Therapeutic Radiological Services: 20% coinsurance
Outpatient Diagnostic Procedures/Tests: $0.00 copay - $70.00 copay
Diagnostic Radiological Services: $100.00 copay - $200.00 copay
|Home health care||In-Network:|
|Mental health inpatient care||In-Network:|
Days 1-5: $300.00 per day, per admission / Days 6-90: $0.00 per day, per admission
Additional Hospital Days: Unlimited additional days
|Mental health outpatient care||In-Network:|
Individual and Group Sessions: $40.00 copay
Outpatient Hospital - Surgery: $250.00 copay
Observation Services: $250.00 copay
Ambulatory Surgical Center: $250.00 copay
|Outpatient substance abuse care||In-Network:|
Individual and Group Sessions: $40.00 copay
|Over-the-counter items||This plan covers certain approved, non-prescription, over-the-counter drugs and health-related items, up to $80 every quarter. Unused OTC amounts do roll over to the next quarter. Unused OTC amounts do not roll over to the next calendar year.|
Medicare Covered Podiatry Services: $0.00 copay - $40.00 copay
Routine Foot Care: $0.00 copay
6 routine foot care visit(s) each year.
|Skilled Nursing Facility (SNF) care||In-Network:|
SNF Days 1 - 20: $0.00 per day / Days 21 - 100: $196.00 per day
The following dental services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Preventive and Comprehensive Dental Combined Allowance
This plan covers up to $1,750 for covered preventive and comprehensive dental services every year.
Medicare Covered Dental: $0.00 copay
Preventive Dental Services: $0.00 copay
Comprehensive Dental Services: $0.00 copay
The following vision services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Medicare Covered Eye Exam: 30% coinsurance
Medicare Covered Eye Wear: 30% coinsurance
The following hearing services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
Medicare Covered Hearing Exam: $50.00 copay
The following services are covered, though there may be provider network restrictions. See the plan Evidence of Coverage.
|Preventive services and health/wellness education programs|
When reviewing Maine Medicare plans, be sure to find out if your doctors are part of the plan network. If a Medicare Advantage plan covers prescription drugs, make sure the plan formulary (list of drugs covered by the plan) includes your drugs.
You may be able to find plans in your part of Maine that offer similar benefits at similar or lower prices than the plan above. Call 1-800-557-6059 TTY 711, 24/7 to speak with a licensed insurance agent who can help you compare plans.
|Links to plan documents|
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