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HAP Medicare Flex PPO

Monthly Premium

  $0*  

Deductible

$0 Medical/
$505 Rx on Tiers 3-5

Max out of pocket

$8,300/
$12,450

Copays (PCP/Specialist)

$0/$40

Dental

$0 preventive - 2 cleanings; 2 exams & a set of bite-wing x-rays; Flex Card option for comprehensive coverage services.

Over-the-counter (OTC) benefit

Flex Card Option

Vision

$0 routine exam. Flex Card option for eye wear or contacts.

Hearing / Hearing Aids

$0 routine exam. Hearing aids covered with Flex Card option.

Flex Card

$1,200 flexible benefit allowance per year with no rollover. You can you use up to $300 every six months on dental, vision, and hearing. And up to $300/every six months for OTC, transportation, companion care,** or a personal emergency response system (PERS)**

Inpatient Hospital

$310/day for days 1-6; $0/day for Days 7-90

Preventive Care

No copay for services considered preventive.

Outpatient Diagnostic Labs, Procedures, Tests

$0 - $260 depending on service.

Emergency Room / Urgent Care

$95/$60

Physical, Occupational and Speech Therapy

$40 per visit; unlimited
* You must continue to pay your Medicare Part B premium. If you have a late enrollment penalty, it will still apply.
** Benefit needs to be purchased through NationsBenefits.

Health Alliance Plan (HAP) has HMO, HMO-POS, PPO plans with Medicare contracts. HAP Medicare Complete Duals (HMO D-SNP) is a Medicare health plan with a Medicare contract and a contract with the Michigan Medicaid Program. Enrollment depends on contract renewals.

Have Medicare questions?

(800) 868-9885 (TTY:711)

Monday-Friday; 8 am to 8 pm